When Your Medical Insurance Is Refusing to Pay

This is one of the most common fears and problems in today’s healthcare system. Being denied, being deprived of medical care is pretty painful and alarming. Especially if you need a healthcare service that is very expensive, or if you need it for a long time. A few things are vital to life, and health and health care are one of them.


If what you need is not covered by the benefit of your plan. Look at your policy once more very carefully. The insurance company can make a mistake. If you are denied because some information is missing, do not wait – call them right away. Find out what information is missing and update them immediately. Do not allow this problem to be delayed. In case your annual exam wich is free is now charged to you, contact them immediately and correct this error.

Medical care from a provider

If you get medical care from a provider that is outside of your network. Know that exceptions are possible only in case of an emergency. Or if you can prove that absolutely no one in your network was able to provide you with such a service or a similar one. In any case, it is very important to always check that the provider is in your network. So that there are no complications and additional billing.


If your treatment code is wrong, know that this happens very often. Your insurance company will inform you that they will not pay, so you will be able to easily find out where the error occurred and report it so that it will be evaluated and corrected. In case your hospital stay is mistakenly encoded as an observation instead of an inpatient. It is very important that you do not sign this paper. With your signature, you guarantee that you have read everything and that all information is correct. So do not make a mistake and sign such paper. It is very important because if you were in need of medical service. Such will not be payed by your insurance company if the code is observation instead of inpatient.