Delayed Claims

The claim has missing or incorrect information. Information may be inaccurate, incomplete or missing. Whether by accident or intentionally, medical billing and coding errors are common reasons claims are rejected or denied.

There are several reasons insurance companies deny claims that are valid and reasonable. For example, if your accident could have gotten avoided or if your conduct led to the accident, your claim may be denied. An insurance company may also deny a claim if you have engaged in conduct that renders your policy ineffective.

The number one cause for a denial is that a patient isn’t eligible for care under the insurance plan terms. In the research cited above, nearly one in five respondents said: “registration/eligibility” was the leading reason for denials.