Persistence Pays Off When Insurance Pays for Its Mistake

Submitted by Daydria Luellen, Medical Bills Auditing Service, LLC

My client was sent a hospital bill back in 2009 for $5875.00 for a MRI. Her insurance company denied the claim stating that the “diagnosis is not consistent with the procedure”. They made it seem as if this error was made by her physician so for a long time I was dealing with the physician trying to get him to change the medical records and the referral.

After much research, I found that the error was made by the insurance company. By being persistent and after speaking with a number of representatives and supervisors at the insurance company, I was finally successful in getting them to reverse their denial and reprocess the claim for payment.

By this time, the hospital had sent the claim to collections, therefore, I had to make sure my client’s credit was not ruined by this. Now everything is fine, the insurance was forced to pay the bill that they were responsible for, the hospital is paid, the bill has been removed from collections and my client is no longer being harassed to pay a bill that she was never responsible for.

At MBAS we’re not done when a claim is paid, we go that extra mile and provide a service to clear your credit if it has been affected as a result of a denial.


February 2012


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