T or F: Insurance companies are rated according to the number of complaints received about them.
If an insured is in disagreement with the insurer for settlement of a claim, a suit must begin within...
If a payment problem develops with an insurance company and the company ignores claims and exceeds time limits to pay a claim, it is prudent to contact the...
state insurance commissioner
A follow-up effort made to an insurance company to locate the status of an insurance claim is called a/an...
What should you do if an insurance carrier requests information about another insurance carrier?
provide the information
An insurance claim for a service that has been bundled with other services would be...
What should be done if an insurance claim denial is received b/c a billed service was not a program benefit?
Send a statement to the patient with a notation of the response from the insurance company
What should be done if an insurance company denies a service stating it was not medically necessary and the physician believes it was?
Appeal the decision with a statement from the doctor
If an insurance company admits that a pt signed an assignment of benefits document and that it inadvertently paid the pt instead of the physician, the insurance company should...
pay the doctor within 2-3 weeks and honor that assignment of benefits before they even try to get the money back from the pt
An insured person cannot bring legal action against an insurance company until __________ days after a claim is submitted to the insurance company.
Monitoring the activities of insurance companies and making sure that the interests of the policyholders are protected are the jobs of the insurance _______________.
All requests of the insurance commissioner must be submitted in writing and include the _________ signature.
An insurance claim that is processsed without following specific insurance carrier instructions is considered a/an __________ claim.
If the medical practice receives payment from an insurance company that is more than the contract rate, it is called a/an...
If inadequate payment was received from an insurance company for a complicated procedure, the insuance billing specialist should file a/an __________ on behalf of the physician.