If Blue Cross, a well known insurance carrier, won't pay your medical provider for treatment you have received, you could be stuck with a huge bill. Instead of paying the bill, you can do certain things to help the denied claim go through. Insurance appeals are a common occurrence and in many cases, the monies owed will be covered or reduced.
Instructions
1. Make sure you have all of your insurance paperwork in order. For instance, if you need a referral from your doctor to receive treatment from a specialist provider, ensure that you have a copy of this before contacting Blue Cross.
2. Call Blue Cross to discuss the denied claim. Ask for the reasons for the denial and see if the claim can be resubmitted. For example, if you were denied because you did not have a referral and now do, the claim can be resubmitted and paid.
3. Prepare an appeal. Many Blue Cross affiliates have a form that you can download online in order to make an appeal and convince the carrier to pay your medical providers. You will need to provide the claim record number as well as your reasons why the claim should be paid.
4. If you have your coverage through work, speak to your company's case manager for assistance in getting a Blue Cross claim paid. Companies with numerous employees often have advisers that can help resolve claim denial issues.
5. Contact a patient advocacy group for help. If you have a serious illness, these advocacy groups can help with the negotiations between you and Blue Cross. One example of this type of group is the Patient Advocacy Foundation.
Tags: Blue Cross, carrier your, carrier your medical, claim resubmitted, denied claim
