All Entries Tagged With: "denials"

National Appeal Process denial

Does anyone have a success story on getting a denial overturned by using the National Appeal Process after all levels of appeals for the insurance company have failed? Also, can someone provide that address?

Rosemary R. McLain, RN
Clinical Nurse Auditor
Providence Hospital

Billing post-denials

A patient came into the office and gave us Anthem Blue Cross and Blue Shield insurance card, so we billed that insurance. Blue Cross denied stating that the patient wasn’t eligible then we billed the patient. The patient comes back after a year later and says, “Oh, by the way I had Cigna insurance.”

So, we bill Cigna insurance, and we get denials stating that it is past timely filing, which we knew would happen.

My question: Is it legal to bill the patient after receiving these denials from Cigna and make them responsible for paying us services rendered? Or, is there a law that forbids us from doing so?

Danielle Bryant

Medical biller

Newington Internal Medicine Primary Care, LLP

Newington, CT