The humana dental amazing yeah it many times it gets bounced back and says humana dental send us an e OB or sometimes they process it as a primary and then you got overpaid yeah and guess.
- What you got a refund it you have to send that money back and get a correction you can’t you can’t have it process as primary or not
- The other thing is if they have private insurance and Medicaid a hundred percent all the time Medicaid is secondary always
- Medicaid is secondary so okay how do I know when I should resubmit a claim well if it’s the first clue.
- would be it’s not paid yeah well but there’s a difference between resubmitting .
A claim that’s denied you can appeal a denial if it’s a if it’s not a good denial but if they’re denying it based on.
the terms of the plan like I only pay for two exams a year and you did a third exam you’re never gonna win that appeal you should not resubmit
That a claim because the policy is that’s why you check the eligibility they only pay for two exams this third exam is the patient portion which you have to build a patient now if it’s a denial based on they don’t think that the two that
The insurance company doesn’t say I don’t think you should have done that but they say it in professional legalese terms I don’t think you should have done .
That then then you can fight it that isn’t but then what you do is you you you send them the clinical documentation and say okay well let’s have a real doctor look at the claim and see if a real doctor thinks that and then suddenly
When you challenge them and you realize that it was just some call center rep that denied the claim then then you get it you get it done so if it’s