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What do you do if insurance payment is denied because service not pre-approved?
Wiki User
∙ 11y ago
This will depend on your insurance carrier and your provider. I would suggest calling your insurance carrier to ask for help. In general, if your provider is out of network, you will need to appeal the denial with the insurance carrier and provide details about why you didn't call to do the pre-approval.
If your provider is in network, they usually cannot bill you if they fail to do a pre-approval. (check with your insurance carrier to verify this) In that case I would contact the provider and tell them they can't bill you for it. If they insist they can, contact your insurance carrier and ask them to send a letter to the provider stating they cannot bill you for the service due to their failure to pre-approve it.
Wiki User
∙ 11y ago
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