Common Denial Reasons
You’re probably wondering, “Why was my insurance claim denied?” Claim denials mainly occur for a few reasons
Examples of such errors include incorrect patient, provider, and insurance information and incorrect or mismatched codes. While mistakes happen and sometimes details are overlooked, NEMT providers can avoid denials simply by using BillPro for faster processing times and error-free documentation.
How to Handle Denial Claims
A denied Medicaid claim doesn’t necessarily require immediate action, but you should address the issue in a timely manner since payers only allow a certain window of time to receive corrected claims.
Once you’ve reviewed the denial, prepare a list of questions and look over your policy and summary of benefits and coverage.
When you’re prepared, contact the insurance company and explain the situation.
If it’s only a small error, the problem may be solved on the spot.
However, if it’s something bigger, you may need to file a formal letter, which can become time consuming.