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Why didn't my insurance cover this?
A message appears on the statement
under the description of the service that indicates the reason
the service was not covered. Typical reasons for non-coverage
are deductible, co-insurance, and not covered by your plan. It
is your responsibility to pay the doctor for these items. In
general, insurance plans do not pay for 100% of services.
Contact your insurance carrier to discuss your coverage. Your
benefit booklet also details your coverage for different types
of services.
Did you bill my insurance?
Insurance is billed for all patients
who provide information at their doctors office. Contact your
insurance plan to verify that the claim was received and
processed. Please contact our office only if you have verified
that your claim was not received by the insurance carrier. If
you do have to contact us, please confirm your insurance plan
information including the plan name and address, your
identification number, and group number. Is my doctor in network? Participation must be confirmed directly with the plan to ensure that the information is accurate. Each network has subnetworks and some are also marketed by multiple entities and names. The only way to be certain is to contact the insurance plan directly.
Which Insurance did you bill? Contact your insurance carrier to determine if the bill was received. If not, please contact us with the correct information.
Insurance needs information from the patient You do not have coverage for these services until you contact your plan. The patient or insured party must contact the insurance company and provide requested information.
What is co-insurance? This is another name for copay or deductible. This is the portion that you must pay to the doctor.
Common reasons for payment denials are listed below:
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