AboutTricia Expertise Has your medical insurance company denied your claim and refuses to pay? Have
you received a pre-authorization and still your insurance company
refuses to pay? How can you get your insurance company to reverse a
denied claim? How do you get a provider to waive your copayment if you
are financially unable to pay? Can a provider sue you for a unpaid bill and
will they? Can a provider send me to a collection agency for a medical bill?
If my insurance company does not pay, am I responsible? If you have these questions or others on why your insurance company is not paying your bills, I can help. I can give you "tricks of the trade" to get your insurance company to pay.
I have limited knowledge on Medicare and Medicaid and that is not my expertise. Each state is very different regarding Medicare and Medicaid so you need to review their website when you have questions. So please no Medicare or Medicaid questions!!
Experience In the medical field for over 20 years spending majority of time in the collections aspect.
Question Hi,
I am a office manager of a pediatric dental office. we have a very big problem with nys medicaid base funded ins company, Doral dental and United. they have not paid a large amt of claims. Doral states "untimely filing" I did tell them I have copies of all claims the were mailed. There answer was " how do we know you really put it in the mail" so they are refusing to pay them but the said they would cut us a deal. United i haven't received payment since Nov or DEC of 2007. they refuse to answer my calls or emails.
please guide me on what we can do about this.
Thank you for your help.
Tami
Answer Hi Tami!
Getting paid by insurance carriers is a big game unfortunately--------you got to keep calling, emailing, mailing until you get your bills paid. The more they hear from you the faster they will pay just to get you from calling them. Call them everyday, email them everyday..continue until they either pay or call you back.
They come up with any excuse not to pay so always send out bills quickly and follow up often to avoid them giving you stupid excuses.
When you call try to speak to a manager, they usually seem to want to help you and will usually get bills processed fast.
The fastest way to get paid is by talking to someone so perhaps try calling at a different time........certain days are usually worse to call such as Mondays and Fridays, so call Tues-Thursday perhaps first thing in the AM or right after lunch. Sometimes when you are on line you can hit the "0" key and get to the operator where you can speak to someone live then explain you need to speak to someone "live".
You can also send a certified letter addressing it to the Manager with all the copies of your invoices demanding payment. We use this tactic alot and it does work since they have to sign for the letter and then they can not use the excuse they did not receive the claims.
