Can OID help?
OID may be able to assist depending on the patient’s plan. File a request for assistance and explain the circumstances involved. Include a copy of the signed assignment of benefits. Why was the claim denied after the company pre-authorized the procedure? Pre-authorization is not a guarantee of payment. It only means the treatment is considered medically necessary. A company determines if a claim is payable after receiving the documentation and claim and reviews it against the patient’s benefit plan/policy. I believe the insurance company/PPO unfairly reduced my billed amount. What can I do? Work with your health care plan providers’ relations contact to resolve your problem. Contracting parties must resolve disputes about contract terms among themselves. You should review and understand your contract before you sign it. How long does an insurance company have to pay a claim? (Title 36 1219) A. In the administration, servicing, or processing of any accident and health insurance policy,
