Wednesday, May 13, 2009

If It’s Friday… It Must Be Time to DENY That Claim!

by Sheri Samotin

I can’t be sure, but after many years of fighting on behalf of patients to get insurance claims processed correctly, I’m convinced that something special happens on Friday afternoons in claims processing departments. Let’s call it the “clean desk rule”; maybe claims processers can’t go home for the weekend until they clean their desks. And, what’s the easiest way to do that? Well, how about pretending those claims don’t exist at all! Sweep them right into the virtual recycle bin, and start fresh on Monday morning. Seriously, the number of times I’ve been told that a claim that was submitted electronically for an established patient was “not received” is remarkable, so my theory can’t be all wrong. Or, if that tactic was used last time, maybe this time they’ll try to say that the provider is “out of network”. Sound familiar? You’ll be unhappy to know that you’re not alone. Read the full article

1 comment:

  1. Thanks for the article! This is such a good advice for our seniors who will soon engage themselves with health care facilities. I agree with you that the "lingo" can be intimidating and difficult to understand especially for our seniors. A hundred thanks to reputable insurance claim advocates! Because of them, no senior will have to endure the complexities entailed by health insurances.

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