As a medical billing/management company, we are given the task to follow up with insurance companies to get the claims paid for any charges turned in to us. Some insurances - like Medicare - make that task easy by having strict regulations in place that we follow and, by doing so, they pay easily and on time. Others will loosely follow guidelines and hold or even deny the same claims, and we are forced to contact them to get that claim paid. Find out how we help get those claims paid.
On-line access with most is marginal at best and does not give out any more information than the denial did. Some have a dispute option you can file to argue that their denial was unjust and that can then be overturned. If there is no on-line feature, you are encouraged (meaning you have to) call them and speak directly to an agent. Hold times since the pandemic have increased dramatically to as much as 120 minutes (2 hours with bad hold music) and then you can only review 2-3 claims with them and they would need to call back again! If you are so lucky as to get through, getting transferred from there to another rep just makes the whole process even more enjoyable.
There are times this whole process is so worth it to get the provider paid for their services rendered and have the insurance company pay the benefits that the patient pays premiums for in the first place. We have appealed many claims and received payments for large amounts of money and did a little "happy dance" at our desks when it comes through. I have sent out a lot of "atta girls" and "atta boys" to my staff to celebrate. Our company charges by a percentage of collections so if the provider does not get paid, we don't get paid so that's motivating,
Some examples of success stories: