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Why insurance claim takes long or gets rejected at Dr.s

by: tumbullweed( 1040Feedback score is 1000 to 4,999)
1 out of 3 people found this guide helpful.
Guide viewed: 518 times Tags: Doctor | insurance | claim | MS | medical


 

In my spare time since I have been hit with MS I was getting educated in a new field in medicine and read something that really flabbergasted me.While your sitting at home wondering whats taking the insurance company so long to approve something or even worse stewing over why something was rejected.......It may not have anything to do with you at all!!!!Most slow claims or rejections are caused in filing claims with errors most are typos or mistakes even the smallest thing can cause your claim to drag on or worse get denied

COMMON ERRORS THAT DELAY CLAIM PROCESSING

1.TYPOGRAPHICAL ERRORS OR INCORRECT INFOMATION ON FORMS.

ex.wrong policy id number,total amounts on bill wrong,etc.

2.OMISSION OF OR MISSING INFORMATION

ex.no diagnosis,wrong dates,wrong name of dr. etc.

3.PAPER CLAIMS HAND WRITTEN

ex.improper alignment on form,staples on a form etc.

HERE ARE 12 COMMON CAUSES OF CLAIM REJECTION

1-patient id # missing on form.

2.group # from insurance card missing.

3.dr. signature missing.

4.dates wrong

5.diagnosis doesn't match procedure.

6.diagnosis doesn't match service provided.

7.Charges not itemized.

8.info missing.

9.fee column is blank.

10.mandatory codes missing.

11.necessary drug/equipment info missing.

12.poor handwriting claim unclear.

Even better heres a few more letter o's replaced with 0's or vice versa.

 Use of lower case when not warranted.

Use of dollar signs,decimals or commas.

Use of dashes,parantheses,spaces, use  of persons title such as sr. jr. unless its on card.

Dates typed in wrong style.

 It goes on and on very horrifying when you think about it. Your  hospital insurance claim could be denied  due to something so silly and not having anything to do with your condition at all.Think of how many people get denied and just let this go.So my advice to all of you........... REFILE REFILE REFILE.

Oh Another thing that might help you... if you think something may have gone wrong during a surgery or you would like a record of all the info doctors record about you and let me prepare you, some of it you may not like but atleast you will be more powerful with knowledge, all you have to do is go to the hospitals medical records department and pay a small fee, sign some papers, and fill out what date you want them for and they will give you a copy.  I was going to many doctors for 2 yrs trying to get someone to listen to me when I was having bizarre symptoms. I just kept getting shuffled around everyone said nothing was wrong til I started going blind and having seizures and my left side of my body went numb. I got all my records together to keep track of all my symptoms and dates etc. Just by reading these doctors notes you could tell who cared, who didn't, and keep better track of everything. Good luck hope something here helps someone!

 


Guide ID: 10000000001618186Guide created: 08/14/06 (updated 11/09/06)

 
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Related tags: child | insurance | burn | bills | personal | coupons | save | medical | family | Doctor | ebay | cd | custom | MS | claim

 


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