Hello,
We are an DME supplier for Braces and we are out of network with the insurance company. Since last few days we have started receiving denial from UHC insurance as "Evidence of misrepresented services". Earlier we use to get paid, this is first we are receiving an denial and all the current claims showing up with the same denials. We have already delivered the equipment to patient and based upon patients plan benefits we have submitted the claim as per patient plan out of network benefits are covered.
Just an FYI - We had called the insurance about this denial. Per insurance representative they require medical records. When we send out the medical records they directly go and upheld it.
Could you please help us to address this denials and come out of this situation.
Thanks,
Prakalp
