What are the reasons for a claim to be denied?
A claim can be denied for many reasons including no coverage at the time of the injury or sickness, expenses that are not covered by the plan, failure to file a claim form or provide additional information, injuries that are work-related, pre-existing conditions, not receiving an itemized bill, and deductible not satisfied.
Related Questions
- If the required NDC information is missing, will the entire claim be denied or just the claim line for the physician-administered drug?
- What required "claim change condition code" do I use when adjusting a denied claim to make Medicare the secondary payer?
- What should a veteran do if his or her claim for disability compensation is denied by VA?
