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What do you think the number one reason is for a denied medical claim and why?
Wiki User
∙ 11y ago
The number one reason for denial of medical claim is due to misconception of the policy holders about medical insurance.In most cases, it has been seen that people having undergone simple medical tests have opted for medical claim, where as medical insurance is only for TREATMENT of illness/disease encountered by the policy holder. The second best reason is "Pre-existing Disease" i.e. existence of disease before taking the policy,which have been concealed. Even if it is declared, there are exclusions for say lst year,2nd year or even 4th year depending on the type of disease. Staying 24 hours in hospital/nursing home is mandatory, where as it has been seen that patient have been discharged on the same day of admission,excepting day care facility for few diseases.Not filling up the claim form properly,TPA's insistence on continuity of policy information from the insurance also delay the process.
Wiki User
∙ 11y ago
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Has your previous disability claim already been denied once this is my question that i need answered?
Only you can say if your previous disability claim has already been denied once; we don't even know who you are, much less what your personal medical and disability claim history may be.
If a medical claim is denied because the provider made billing errors is the patient responsible for payment?
The patient is responsible for the cost of all medical care.
What do you think the number one reason is for a denied claim and why?
The number one reason for denial of medical claim is due to misconception of the policy holders about medical insurance.In most cases, it has been seen that people having undergone simple medical tests have opted for medical claim, where as medical insurance is only for TREATMENT of illness/disease encountered by the policy holder. The second best reason is "Pre-existing Disease" i.e. existence of disease before taking the policy,which have been concealed. Even if it is declared, there are exclusions for say lst year,2nd year or even 4th year depending on the type of disease. Staying 24 hours in hospital/nursing home is mandatory, where as it has been seen that patient have been discharged on the same day of admission,excepting day care facility for few diseases.Not filling up the claim form properly,TPA's insistence on continuity of policy information from the insurance also delay the process.
will work comp pay my initial medical bills before the claim is accepted or denied?
yes they will pay the medical bills if they are the reliable company otherwise you have to file case and get your asset
What if your workmen's comp claim is denied?
If you claim is denied, you can try and appeal it. You will only be given workmen's comp is the injury happened on the job.
What type of lawyer should I hire if I have a Medicare claim?
A Medicare attorney is the best choice for general Medicare claims. If you specifically have a claim that has been denied, there are even lawyers who specialize in denied claim cases, frequently referred to as denied claims attorneys.
Can you request a new adjuster on a claim if another adjuster denied the claim?
No, but you can ask for reconsideration of a denied claim. When reconsideration has been requested, it is standard practice that a different adjuster will be assigned for the reconsideration.
Where can one find reviews on medical claim software?
One can find reviews on medical claim software on several different review sites. There are a vast number of sites that contain reviews on various products and medical claim software will be one of them.
How do you appeal when the car insurance company finds you at fault and you are not?
Please give me more information, and I'm sure I can help. Facts of loss? Exact reason they denied your claim? They must give you the reason that your claim was denied, or that you were found neglient. You can file with your company then they can arbitrate the claim for a decision, you can contact the dept of insurance for your state. You can file suit (small claims if under the limit), if you secure a judgment against their insured they will have to pay, (barring any appeals of course), but need to know the reason for denial, to be of real help to you.
Can a workman's comp claim be denied if you do not pass the drug test?
Yes, a workman's comp claim can be denied if you don't pass the drug test. If you were on drugs, it might be your fault that you were injured or hurt.
Is there a deadline for billing an insured for services denied by an insurance company?
Yes. If the medical provider wants to challenge the denial then the medical provider must submit his request for reconsideration within a certain time limit. The bill-er would have to contact the insurance company to find out when the time limit ends and if the denied claim can be re-billed with special documentation.
What could be the possible outcome of inaccurate medical billing?
If there is inaccurate medical billing information in a claim then there could be a reimbersment could be made at a reduced rate or the reimbersment could be denied. Both of these would reflect badly on the practice and loose the practice money.
