How to Resolve Health Insurance Billing Errors

Health insurance billing errors are errors that may result in you receiving a bill from your doctor that you should not have received. As an insurance claim goes through processing, there is sometimes confusion between the procedures that were done, what is billed and what is actually paid. There are several steps that you can take to resolve health insurance billing errors.

Things You'll Need

• Telephone
• Explanation of benefits from your insurance company

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Instructions

• 1

  Call your health care provider to confirm what services were done,and what were billed. If there is a discrepancy, ask the office manager to look into the matter. If the doctor's office billed the insurance company for the wrong procedure or for extra procedures, ask it to send in a new claim to your insurance carrier.

• 2

  Ask your health care provider for the medical codes that should have been billed. Write down the numbers she gives you. Check your explanation of benefits from the insurance company to see if the numbers match. If they do not, ask the office to resubmit the claim to your insurance company with the correct codes.

• 3

  Call your insurance company and confirm that the codes that you have from your provider are the same codes that were on the bill sent to the insurance company. If they were, but your explanation of benefits shows otherwise, ask them to reprocess the claim.

• 4

  Start an appeal. In many cases, an appeal must be presented in writing within a certain time. Ask your insurance representative how to appeal and follow his directions carefully.