Getting paid is an important part of business but when working through insurance companies, claim denials happen often. Avoiding them is critical. However even though it is likely that a practitioner can expect to experience a claim denial at least one or more times during their career, that does not mean that dealing with them won’t be difficult and frustrating.
The Leiva Law Firm is a Los Angeles business litigation law firm that can help you if you have a claim denial. It is imperative to have experienced and resourceful legal counsel and representation to build a strong case that will get you the results you need. When you need assistance with a claim dispute, you can count on the Leiva Law Firm to assist you.
What to do When a Claim Has Been Denied
Managing a claim denial can be time time-intensive, complex, and a stressful task to take on no matter who is responsible for it. However, getting to a resolution is critical because without a one a practice can feel the financial pain that comes with an interruption in cash flow.
When an insurance claim is denied some of the following strategies can help a practice take the right steps to remedy the problem.
- Make sure to read the information that the insurance company provides as to why a claim was denied. Reviewing the information carefully is key to knowing what is happening and what to do. Sometimes, the reason a claim was denied partially or completely is due to missing information or information that was submitted that was incorrect. The correspondence from the insurance company should outline what the issue is and what needs to be done to have the claim paid. This may come by a resubmission with updated materials or by filing an appeal.
- When you are unsure about the directions or the information you are given, take the time to call the insurance company and speak with someone and determine what the problem is and what exactly must be done. You may find that the issue was a mistake that the payer made or you could find out the exact procedures and requirements necessary to resubmit. From there you can adjust your internal process to make sure things are done correctly in the future.
- When you have taken the time to understand what the issue is and you made adjustments for resubmission but you still are denied, then it may be necessary to file an appeal. Updating yourself on the insurance’s rules for appeal and state laws can help you with this.
- Be proactive when a claim is denied. It is imperative that you do not delay or wait to get into the issue and get a denied claim resolved. There is only a limited time to do this and if you fail to get this done in time, then it is likely that the money you were looking forward to won’t be paid.
- Always keep organized records of claims that are submitted and actions are taken when claims are denied. This includes taking notes on whomever you communicated with and when the communication happened. If legal action is necessary your records can support your case.
Speak to an Attorney at Leiva Law Firm Today
If you need help with a claim denial you are invited to call the Leiva Law Firm at (818) 519-4465 to schedule an initial consultation with an experienced attorney.
