Coverage Denials

Coverage Denials is a legal determination by a health insurance provider, acting within the framework of an insured health benefits plan, that a requested medical service, treatment, or claim does not meet applicable criteria for reimbursement under the terms of the policy, thereby excluding it from the scope of covered benefits.

Publications

2.1K

Citations

177

Authors

Institutions

Publications per year

2017–2026

Parents

Health Insurance Law

Children

Bad Faith Insurance DenialsClaim Denial Reason CodesCoverage Policy InterpretationEmergency Care Coverage DenialsErsa PreemptionFormulary ExclusionsHmo Coverage DenialsInternal Review ProcessesInvestigational ExclusionsManaged Care Coverage Denials

Publications

Consumers’ misunderstanding of health insurance

George Loewenstein, Joëlle Y. Friedman, Barbara McGill et al. · Journal of Health Economics · 2013 · 268 citations · Full text

Law, Health Policy, Insurance +12

Time-Consistent Health Insurance

John H. Cochrane · Journal of Political Economy · 1995 · 226 citations

Business, Health Care Management, Insurance +17

Disparities in Absolute Denial of Modern Hepatitis C Therapy by Type of Insurance

Vincent Lo Re, Charitha Gowda, Paul Urick et al. · Clinical Gastroenterology and Hepatology · 2016 · 128 citations · Full text

Pharmacy, Health Policy, Insurance +14

The Complexity Of Billing And Paying For Physician Care

Joshua D. Gottlieb, Adam Hale Shapiro, Abe Dunn · Health Affairs · 2018 · 84 citations

Health Professions, Health Policy, Insurance +17

Responsible Artificial Intelligence in Healthcare: Predicting and Preventing Insurance Claim Denials for Economic and Social Wellbeing

Marina Johnson, Abdullah Albizri, Antoine Harfouche · Information Systems Frontiers · 2021 · 81 citations

Computing, Computer Science, Health Informatics +16

1–5 of 55

Authors

177

DM
David M. Studdert
The University of Melbourne, Australia
3 publications · 50 citations
3
h-index
CR
Carole Roan Gresenz
RAND Corporation, United States
3 publications · 50 citations
3
h-index
JR
Jay R. Kostman
University of Pennsylvania, United States
2 publications · 202 citations
2
h-index
CG
Charitha Gowda
University of Pennsylvania, United States
2 publications · 202 citations
2
h-index
VL
Vincent Lo Re
University of Pennsylvania, United States
2 publications · 202 citations
2
h-index

1–5 of 177

Institutions

1–8 of 83

Venues

Health Affairs
7 publications · 190 citations
7
h-index
JAMA
4 publications · 69 citations
4
h-index
American Journal of Law & Medicine
2 publications · 28 citations
2
h-index
PubMed
Repository · 2 publications · 25 citations
2
h-index
Journal of Health Politics Policy and Law
JHPPL · 1 publications · 35 citations
2
h-index

1–5