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Introduction to Denials


A denial occurs when the claim you submitted has one or more problems the payer wants you to fix before they will send you a check.

You will need to figure out what the problem is and resubmit the claim from scratch. When you do that, the clock resets as though you had never submitted the original faulty claim to begin with. Count on waiting a month, give or take, to get the reply, which also could be a denial.

Insurance companies LOVE to issue denials. They've been collecting premiums (and heaven forbid they don't receive them on time), and the money they owe you remains in their pocket, an interest-free loan from you that I am sure they are grateful for. They may even erroneously issue a denial on a perfectly valid claim. We'll talk about how to deal with that in a future blog post 

In the next few blog posts, we'll talk about the most common reasons insurance companies give for denying your claims.

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