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HealAssist

If your cashless pre-authorization is rejected

Quick answer

A rejection is not the end of the road. Your HealAssistant reviews the case and helps with whichever route fits: re-filing the pre-authorization with a stronger medical justification, appealing with the insurer, or switching to reimbursement or self-pay. Contact your HealAssistant — there is no appeal button in the HealAssist app.

A cashless pre-authorization is the insurer or TPA approving your planned treatment before admission. A rejection is about how the treatment would be paid for, not a decision about your care. Your HealAssistant works the case with you.

What HealAssist does when a pre-authorization is rejected

Your HealAssistant reviews every rejection case by case — the reason the insurer gave, your policy terms, and where you are in your treatment all change the right answer. HealAssist prepares the medical justification with the treating team and re-files immediately where re-filing is the right move.

The approval decision always belongs to your insurer or TPA. No platform can guarantee it, and HealAssist will not pretend otherwise. What HealAssist commits to is the work: preparing the medical justification, re-filing, and following up.

The routes open to you after a rejection

  1. Re-file or appeal with the insurer

    Many rejections come down to missing or weak medical justification. HealAssist prepares the documentation with your treating doctor and re-files immediately, then follows up with the insurer hourly until it clears. How long the insurer takes on a re-filed request is their call.

  2. Switch to reimbursement

    You pay the hospital and claim the money back from your insurer afterwards. HealAssist helps you prepare and file the reimbursement claim so it is not your paperwork to fight alone.

  3. Proceed as self-pay

    If the treatment cannot wait for the insurer, your HealAssistant coordinates a self-pay admission with the hospital, and can still help you pursue the claim afterwards.

Rejection questions

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