Denials | Appeals | Insurance Contacts


Denials | Appeals | Insurance Contacts

Denials occur because of communication breakdown between an insurance company and the client’s office. Continuing follow-up enables Pro Med Billing Solutions to resolve problems related to denials.

A frequent explanation for denials is that care was “not medically necessary”. Pro Med Billing Solutions finds this explanation unacceptable. We immediately contact the insurance company and obtain information on why and who determined the procedure was denied. We then escalate the issue until we reach a satisfactory result.

We have established contacts (Analyst, Case Manager, Adjustor, etc.) in the review department at most insurance companies, which is a successful way of determining where communication breakdowns occur. Our contacts discuss the reason for denial with members of our staff, so we can determine the appropriate course of action that will lead to payment.

Our proven dispute management technique enables us to resolve denials quickly and effectively.