Question
My dad's insurance refuses to pay a claim. The doctor's office called to get pre-authorization and to get the correct code to file the surgery under. We have written one letter and the insurance company still refuses to pay the claim. What can we do to get this claim paid?
Answer
Hi Sherri!
You need to find out the exact reason for the denial. Then you can usually appeal twice disproving their denial.
However once you exhaust the appeal process not much more you can do than call the Dr's office and try to negotiate the balance down. If it was due to a lack of authorization that the Dr's office did not obtain, then you can usually negotiate your balance down alot.
Good Luck!
Tricia
