Appealing Denials and Exposing the Tactics of Insurance Companies, Attorneys and Third-Party Payers!
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Delaying & Stalling
What to do when insurance companies say…
- “It’s being processed”
- “We never received it”
- “We need more information”
What to do when they…
- Ignore you, or never respond with anything
- Write poor language on the explanation of benefits statement that splices your relationship with your patient
- Play games with you
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DenialsHow to get paid when insurance companies deny payment with the excuse…
- “It wasn’t medically necessary”
- “You filed untimely”
- “We paid the patient. Go collect from them.”
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Reducing Payments What to do when insurance companies…
- Pay you less than what was agreed upon
- Say your fees are “NOT USUAL, CUSTOMARY, OR REASONABLE”.
- Say you owe them money.
What to do when the attorney…
- Tries to get you to discount your bill
- How can I collect the full amounts?
- How do I better negotiate with attorneys?
- Should I charge for medical record requests? How much?
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What Insurance Companies Don’t Want You to Know About HMO and Out-of-Network Patients
- How do I see HMO patients if I’m NOT contracted?
- How much should I charge?
- I do have an HMO contract, how do I increase my pay?
- How do I increase my reimbursement?
- Why saying, “We don’t take that insurance” can kill your business.
- Do I have to verify benefits with EVERY patient?
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