Most insurance companies use stall tactics to delay payment. Do not let them get away giving you inaccurate information. Do not be afraid to challenge the insurance representatives when you are certain about an incorrect denial. If you are not happy with the kind of response you got from the insurance representative, try to reach their supervisor. Check for missing or invalid items that could hold up the claim from immediate payment. If you develop good rapport with at least one insurance representative for each carrier, you may be able to convince them to give you more details about the claim than usual.
If it is more than 30 days from the billing date, contact the insurance company as follows:
1. Analyze the account and be well prepared before you call the insurance company.
2. Have all the possible requirements ready that can fix the claim at your disposal, such as medical records, W9 form, corrected claim, etc.
3. Ask one or more of the following questions:
•What is the status of the claim?
•When is the claim scheduled for payment?
•Why is the claim taking so long to process?
•Why is the claim pending or under review?
•Where do I need to send medical records?
•Who can I speak with to get this claim paid faster?
•Why is the claim not being paid according to contract?
4. If applicable, remind the representative about the prompt pay law.
5. Send a bill to the patient so that they call you or the insurance company.