F.A.Q.

BILLING AND INSURANCE FAQ BILLING AND INSURANCE FAQ 1. I just received a bill and North Medical did not submit the claim to my insurance company? The most likely reason for this is that we did not have your insurance information at the time of your visit to submit the claim to your insurance carrier. Please call our office and provide the necessary insurance information and we will be happy to submit the claim. In most cases we will submit claims directly to insurance carriers; however in some instances, claims may need to be submitted directly by you. 2. Why didn’t my insurance company pay on this claim? Some insurance plans require that a yearly deductible be met before payments are made by the insurance carrier. Subscribers need to understand their plans and what their deductable, co-insurance and co-pay requirements are. Please contact your insurance carrier if you have any questions regarding your deductible, co-insurance and co-pay requirements. 3. Why can’t you give me information on my husband’s account? The new HIPAA (Health Insurance Portability & Accountability Act of 1996) privacy rules limit what information we can discuss with others. Unless your spouse provides written permission to speak to you, we can not discuss bills or any other insurance related questions or information with you. 4. Why was my claim denied? There are many reasons that a claim might be denied by your insurance carrier. Please refer to the EOB (Explanation of Benefits) which was provided to you by your insurance carrier with the denial reason. Please call your insurance carrier with any questions you have regarding their denial of the claim. 5. Why isn’t my Medicare Part B paying for my service? Medicare Part B will not pay claims if you have signed up for a Medicare replacement product such as Today’s Options, Secure Horizons, Medicare Blue PPO, etc. These alternate insurance plans take the place of Medicare Part B and we need to submit your claims to them. Please contact our office to provide us the necessary information for your insurance carrier. 6. What if my insurance company is not listed as a participating insurance on the website list? If your insurance is not found on the Participating Insurance List, please reference to the section titled Participating Network List. If the name of the network on the list is printed on your insurance card, then North Medicaland its providers are participating. If your insurance company/network is still not found, please contact your insurance plan for the most up to date information on the participating status of the North Medicalproviders. If you still need assistance, please call our Billing Office at 315-452-2500