[CocaKoala]

Eh, we're currently fighting to get some claims covered. Before a certain date, all the claims are denied; after a certain date, all the claims are approved. The claims are all for the same thing, related to the same procedure (physical therapy after a joint replacement).

Could the claims have been rejected due to a simple human error? Sure, it's plausible. Was there another human error that caused the claims to be rejected after we appealed? Maybe, but probably not. Could a third human error cause the claims to be rejected again after our second appeal? Seems pretty unlikely.

[quadrifoliate]

Yeah, in your case it seems reasonable that the denials are malicious.

I guess I'm not seeing why the poster I was replying to declared that getting access to the claims file was useless. Wouldn't getting access to that file make it easier to prove that claims were wrongfully denied?