Everything you need to know about authorizations & denials.
Insurance carriers typically authorization decisions based on:
Your policy details; and
The clinical data submitted by your healthcare provider.
Lakeside Billing will help you submit several types of authorization requests to maximize coverage and reimbursement for your required treatment, including:
Pre-authorizations
Single case authorizations
Retro review authorizations
Multiple levels of care
Authorization requests and claims are denied for many reasons -- but don’t panic. Lakeside Billing has a fantastic track record in successfully appealing denied claims.
If you receive a denial letter, contact us immediately at denial@lakesidebilling.com so we can devise and execute an effective appeal strategy on your behalf. This strategy will often include very persuasive clinical data from your healthcare provider.
Admission has taken place. The benefits have been verified . . . Great! What happens next? How do we know what’s going on?
You will be receiving emails from Lakeside Billing with status updates all along the way, however we welcome your call if you have questions or concerns about your coverage and reimbursements.
Please phone our office at (385) 225-3330 anytime you would like an update. Our offices are open Monday though Friday, 9:00am - 5:00pm Mountain Time.
Claims payments are generally sent directly to your healthcare provider. Some insurers will send payments directly to you (especially Blue Cross/Blue Shield and AETNA).
If you receive such a payment and an Explanation of Benefits, please be sure to send us a copy to EOB@lakesidebilling.com. That way we can verify that your policy paid correctly.
If your provider is paid directly, you should receive and Explanation of Benefits from your insurer. Your healthcare provider will process this payment and apply it to your account.
Anytime you receive any communication or payments from your insurer please send us a copy via email to EOB@lakesidebilling.com.
This will assist us in knowing what to do next and making sure your claims are being paid correctly.
CONTACT USLakeside Billing’s Comprehensive Claims Solution is designed to get your treatment covered.
