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Insurance Didn't Pay

October 27th, 2014 at 10:08 pm

I received some mail today, one was a bill for an eye exam my daughter received last November! It shows the claim being denied with an invoice of $79 due upon receipt. It also states it is over 60 days due which implies we should have received an invoice prior. I will be calling and getting this straightened out before next months appointment.

The other piece of mail was from our dental provider indicating they are denying our claim of services in August because the dentist is not a network provider. This I did know. However, the dentist office said our insurance company is still paying claims at the old negotiated rate. I know the insurance will still cover at a certain rate, and at a minimum I will owe the difference. I need to call the dentist office to see what they know. I may need to file our own claim, which I do not look forward to.

I don't like getting bills for services I expected to be covered!

2 Responses to “Insurance Didn't Pay”

  1. FrugalTexan75 Says:
    1414453203

    That would be maddening!

  2. snafu Says:
    1414454442

    How do they explain the huge lag time between a November 2013 procedure and a late October demand for payment? Does your insurance notify you of rejections or do they reconsider if you present cogent arguments? How do you know what they will or will not pay? I've the impression they reject about 1/3 and if the client doesn't argue the decision, they enhance their profit margin.

    Do you have a canned outline to help present the problem and how you expect them to 'fix it?'

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