Patient provides someone with a Cigna card. The front desk scans it, smiles, and sends the patient back to the room for an exam. Three weeks later. Claim denied.
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A claim goes out on Monday, clean as far as anyone can tell. By Friday, it’s sitting in the denied pile with a code nobody at the front desk
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Most payers send you a denial. Kaiser can leave you staring at nothing. The claim goes out. The clearinghouse says it’s accepted. Then 30 days pass, and you find
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A patient hands over a Molina card. Your front desk scans it, books the procedure, and moves on. Three weeks later, the claim comes back denied. Coverage ended the
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You scheduled the procedure. The patient showed up. The doctor did the work. Then the claim gets denied again because no one got Cigna’s approval ahead of time, or
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Humana may underpay you, deny you, or hold your claim for weeks. Sometimes, all three issues occur for a single patient. In response, most practices make more phone calls,
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A patient hands your front desk a Kaiser card. You run it the way you’d run any other, you see the visit, and three weeks later the claim comes
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A claim comes back from UnitedHealthcare with a denial code and a deadline nobody on your team noticed. Multiply that by a few dozen a week and you have
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You saw the patient. The note is signed, the codes are right, and the claim went out the door. Then the remittance lands with one line: “Time limit for
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Your claim was coded correctly. A physician ordered the service. The patient needed it. And the plan still says no, because a reviewer who never met the patient decided
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