Insurance Claim Denial

[12Jay]

Hey has anyone faced an insurance claim denial? Any helpful groups, resources, or services that guided you on the best way to fight it?

 

[Chazm]

File an appeal. That’s all you can do.

 

[LostDollar]

File an appeal. That’s all you can do.

My luck with appeals on Employer Health Plans has been mixed.

I won one I should not have, and lost one I should have won.

As I told OP in his other thread, I have also had situations where, after reading the reasons for decline on the eob, I have been able to determine the denial came from a provider coding error. Once I asked the provider's bookkeeper to resubmit the claim with correct coding, it was paid without any further problem.