Author Topic: Denied Claim  (Read 886 times)

jberubedo

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Denied Claim
« on: January 13, 2016, 07:23:05 PM »
I have a question. The claim that I sent to the insurance for my services as a mental health therapist were denied because it said "claim total denied charge amount". I think that means that I was charging too much for the service. How do I know how much to change for my services?

Thanks!

PMRNC

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Re: Denied Claim
« Reply #1 on: January 14, 2016, 09:31:56 PM »
Quote
The claim that I sent to the insurance for my services as a mental health therapist were denied because it said "claim total denied charge amount". I think that means that I was charging too much for the service. How do I know how much to change for my services?

What did you bill?
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rdmoore2003

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Re: Denied Claim
« Reply #2 on: January 15, 2016, 03:03:53 PM »
Are you participating with the insurance?  A provider can charge any amount they set for services, but that in no way means they will get that amount.  If you are participating, you have a fee schedule with that insurance company.  If you are not in network, it will be based on U&C charges.
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Michele

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Re: Denied Claim
« Reply #3 on: January 19, 2016, 10:38:19 AM »
I have a question. The claim that I sent to the insurance for my services as a mental health therapist were denied because it said "claim total denied charge amount". I think that means that I was charging too much for the service. How do I know how much to change for my services?

Thanks!


You need to contact them and have them explain the denial.  They wouldn't deny if you charge over the U&C, they would just cut the fee back to their allowable.  Sounds like the denial isn't really accurate or you need a better explanation.
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