Therapy Billing Insurance: Why Claims are Denied (reason 12 of 17)

The Provider isn’t Paneled

If a provider sees a patient, but isn’t a paneled provider with the patient’s insurance company, the claim will be denied. This sounds like common sense, but with insurance companies changing names and merging, this happens somewhat frequently. Also, if a provider was working for a larger clinic, he or she might think that he is a paneled provider, when really he was working under his employer’s contract with the insurance company.

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