What are some of the reasons why my medical or dental bills are not being paid by the insurance carrier?

Question:

What are some of the reasons why my medical or dental bills are not being paid by the insurance carrier?

Answer:

Reasons for this would include:

  1. The provider (doctor, facility, etc.) is not in your network.
  2. The insurance carrier may have no record of the referral (if the procedure for which you are being billed required a referral from your PCP).
  3. The provider never billed the insurance carrier.
  4. There is a “coding” problem on the bill from the provider’s office.
  5. Depending on your plan, it may not be a covered expense.
  6. Your plan wasn’t in place on the date of service.

As a reminder, please fax to us any bills in question at 770.499.9882. Claims resolution assistance is one of the services we gladly offer our clients.