What should I do if my insurance claim gets denied?

First, before contacting your plan, try to identify the cause of the denial and possible avenues for remediation. Look on the EOB for a denial code and descriptor, also called reason code or notes. Read them and be ready to address them. You should also:

• Know your deductible.
• Know your benefit and session limits.
• Know when to submit your claim.
• Understand that some claims with pre-authorizations are difficult to process correctly the first or even the second time.

For more information about dealing with insurance claim denials, see our article Insurance Claim Denials and Appeals 101.