Billing: Recourse for denied claim? (after an approval)

[GTSalex]

We recently had a therapist who input a lower amount of total units for care, so when the insurance company got the claim it was only for 1/4th of the services. She did not catch the problem until we received a check in the mail for a much lower payment than expected. We tried to re-submit those claims after updating them, but they were denied (not rejected). I am thinking this means that we have to accept the lesser payment since those claims had checks sent out; but wanted to confirm. Thanks for the info!

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[dpmd]

We recently had a therapist who input a lower amount of total units for care, so when the insurance company got the claim it was only for 1/4th of the services. She did not catch the problem until we received a check in the mail for a much lower payment than expected. We tried to re-submit those claims after updating them, but they were denied (not rejected). I am thinking this means that we have to accept the lesser payment since those claims had checks sent out; but wanted to confirm. Thanks for the info!

It probably got denied as a duplicate. I think you will have to file a corrected claim and ask them to reprocess. Or appeal with the explanation.

 

[GTSalex]

It probably got denied as a duplicate. I think you will have to file a corrected claim and ask them to reprocess. Or appeal with the explanation.

Yep, this is what the eventually told us! Thank you