Within the last few years, the health care system has made some major overhauls and seen changes that many may agree are for the better, and others beg to differ. While having an insurance policy in place is a requirement, unless you want to pay the penalty come tax time, there are certain precautions you can take to avoid having a claim denied as that is the last thing anyone wants to receive, especially if you are undergoing treatment for a serious health condition that has already taken majority of your energy. But, insurance claim denial lawyers in Florida believe there are some conditions that could possibly increase your chances of having your claim denied, and they want you to avoid them.
Whether you have a private health insurance plan covering your doctors visits or you purchased your policy through Obama Care, it is important to know what is covered, and what isn't. This is the first condition you want to be sure you have a firm understanding of as some insurance policies simply will not cover certain types of treatments, or limit you to the number of services that can be provided for that particular illness or concern.
Pre-Authorizations and Referrals
If you seek treatment from a specialist or another physician, they may require you to bring a referral or pre-authorization before they even administer the procedure. For example, let's say you need an MRI or a CT scan. These procedures are generally high in cost, and in the event the doctor you visit performs this procedure without the required forms filled out by your health care professional, chances are your visit will be denied and your insurance company will be seeking payment from you.
Like all humans, mistakes happen. If you received a denial notice, and you already checked to ensure you would be covered, there may be a typo or other written error on the doctor notes or visit overview when your visit was billed out to your insurer.
The Wrong Insurance Company was Billed
If you are lucky enough to have more than one health insurance policy, denied insurance claim attorneys in Florida want to bring awareness to the fact that if you doctor bills the wrong insurance company, you will likely receive a denial notice. Your primary insurance policy is required to be billed first before a secondary policy can pick up any charges that the initial policy didn't cover. When you go in for medical care, be sure you provide you doctor with the right policy information.
There are occasions when a visit with a health care professional may be denied and none of the above mentioned were a contributing factor. While you are legally permitted to file an appeal, in the event you need legal advice as your insurer neglects to comply with your needs, obtaining aid from a Florida insurance claim dispute attorney is something you may want to consider.