General Category > General Questions

Non paid claims

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PMRNC:

--- Quote ---We are a medical clinic (we have two family practitioners) and there are some claims that its impossible to get paid, and we can not bill patient.

--- End quote ---

I suggest doing an analysis so you can determine common denominators to help you maximize reimbursement. You don't say how many but if there are many and you can't bill patient, I suggest looking very closely at your carrier contracts, make sure you are utilizing ABN's properly, and look for possible coding problems. Once you identify your problem areas you can then move forward and reduce denials.

Jdave111:
maryanashaban, What state is the provider located in? For example there might be applicable laws whereas the insurance must pay the claim, with interest and penalties! California has such laws AB1455.

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