Have you been denied a medical claim in the past and worry that future claims could be denied as well? When you purchase medical insurance in Alpharetta, GA, you do so with the expectation that your medical needs and subsequent bills will be honored. When this doesn’t happen, it could leave you feeling unsure about your care and concerned about how you’ll pay the bill.
Buying popular insurance in Alpharetta, GA, doesn’t guarantee every claim will be approved. It’s unfortunate, but claims get denied every day for numerous reasons. Here are 5 common reasons claims are denied.
It’s hard to believe in today’s electronic age that insurance providers still accept written claims, but some do, and some even require handwritten paperwork. Unfortunately, if your handwriting is difficult to read, this could affect your claim being processed and approved.
The fastest way to a denial is submitting the wrong coding or information that isn’t specific. What’s most frustrating about these claim denials is that the individual is helpless because it’s an issue between the biller and the insurance company. If you get a claim that’s been denied because of incorrect coding, call the biller (your doctor or the hospital) and ask them to review the coding and resubmit.
When submitting a medical claim, you must include all information requested. Failure to include any data requested off the form is a perfect excuse for a detail-oriented payer to automatically deny the claim. Something as simple as forgetting to include your middle initial can cause your claim to be denied. The most common items left off of claims that affect approval include the following:
Payer Requires Perfect Claims
When you receive an insurance quote in Alpharetta, GA, ask the broker if they are familiar with the payer’s claim sensitivity. Some payers are pickier than others when it comes to paying out. If you end up with one of these insurance providers, you and your billers need to be careful and submit flawless claims whenever possible to make sure everyone gets paid in a timely manner.
Missing the Filing Period
Of all the reasons for a claim denial, this is the most frustrating. All payers require claims to be submitted within a timely manner. What adds to the frustration is that each payer has a different filing deadline. If you have several claims to file, it gets confusing and it’s easy to mix-up deadlines. The last thing you want is a timing window error to affect your claim’s approval. If you believe you’ve been denied unfairly because of a filing period mix-up, speak with your insurance provider to try and remedy the situation.
No matter what the reason for the claim denial was, it’s important to review every claim denial carefully. Too many people accept the denial without question and end up paying out of pocket when it’s not necessary.
Do you need medical insurance for yourself or for your employees? Contact Popular Auto Insurance for all medical, auto, and small business insurance in Alpharetta, GA.