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Common Reasons for Insurance Claims to be Denied

There are several common reasons that claims are denied for psychiatry appointments.

What should I do if insurance denies my claim?

1. Information is needed from the patient

This can be resolved by contacting your insurance and providing them with the information needed to process your claim.

2. Information is needed from the clinic

It is not uncommon that an insurance company will request information about the provider you saw or they may request the provider’s note from your appointment to determine payment

3. Insurance inactive for that date of service

If you feel that it is incorrect you will need to contact your insurance to resolve any issues. Any claims denied for inactive coverage go directly to patient responsibility and are due 30 days after the determination has been made.

4. Documentation doesn’t support level of service

Insurances typically use non-clinical claims adjusters to review medical records for payment determination. Our office regularly audits medical records to ensure accurate billing and coding practices. An appeal should be submitted in this circumstance by the patient.

Any information needed from WECG can be requested by the patient, give us a call for more information.

 

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