Insurance Type:


Enter Zip Code:



What is Patient’s Financial Responsibility When Insurance Company Adjusts Claims?

What is Patient’s Financial Responsibility When Insurance Company Adjusts Claims?

My dental insurance company processed a claim by my dentist and denied it because of their contractual agreement with the provider that any fillings re-worked within 2 years are not the patient’s responsibility. The provider’s benefit statement regarding this service states, “The amounts shown as payable by you and by Delta Dental are in accordance with the terms of your dental plan and the terms of our agreement with your dental provider.” The benefits statement shows my 80% benefit level for this service. The insurance company is not saying that I am ineligible for the benefit. Rather, they are saying that the dentist is not eligible to be paid for this service (by either the insurance company or me) based on his contract with Delta Dental and the benefits to be provided by Delta Dental and paid by the customer. The benefits statements includes notes explaining why the claim was denied. The underlying question is: “What is the patient’s responsibility when the insurance provider says it is zero in accordance with the insurance agreements that all parties are abiding by?” Said differently, “Is the insurance company the final arbiter of amounts owed by the patient?” Does the insurance agreement prevail? Or does the doctor truly have the right to demand payment for amounts that the insurance company says the patient does not owe? I realize the patient is responsible for co-pays and deductibles. But I am pretty convinced that if the insurance company is denying the claim and also stating the patient has no responsibility, then the patient truly has no responsibility until and unless the provider gets the claim processed differently. The provider agreed to be bound by insurance processing when he agreed to accept this provider and its terms and benefits. Insurance companies routinely adjust the “submitted fee” downward to the “accepted/contractual” fee and providers routinely accept those adjustments (and that is one of the reasons we have this complex insurance system: to adjust charges to reasonable levels and protect patients. We pay tons of premiums for this benefit). It makes no sense to then claim the patient owes other amounts that the insurance company says the patient does not owe.

BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes


RELATED:

Did you hear about Obama’s new auto insurance plan?

Right now people are paying hundreds of dollars a month for auto insurance. THe more accidents you have the higher your premiums are. Then there are those with no auto insurance, we all pay for them when they wreck our cars. Now there’s going to be government exchange car insurance pools. If you don’t have auto insurance you will have to pay a small tax, like a hundred dollars a year. THe great thing is you can buy the government insurance AFTER you have a wreck- you can’t be excluded for your car’s pre-existing condition. Now we can all drop our private insurance that was costing many thousands a year and pay the tiny penalty tax. Just one question? Where does the money come from to repair all the cars?


How much is car insurance for a 16 year old boy in Iowa?

I am turning 16 soon, and I am planing to get a car. Before I do I want to know how much insurance is… Boy, 16, Unmarried.


My car insurance was canceled while on vacation please Help?

I have been on vacation in Calgary Canada for around 8 months my car insurance company progressive” revoked my insurance because I didn’t respond to something they sent in the mail. My home address is in New York and they won’t reinsure me at all. And they directed me to obtain Canadian insurance which requires me to be a resident of the Province and register my car


Is there anyway I can get insurance coverage for a vehicle if I don’t have a license?

I am a senior citizen and have never driven. I need transportation desperately. I can purchase a car but find I cannot get insurance for any driver of my car if I don’t have a drivers license. I have not been able to find anyone I would really trust to put the car in their name. Any suggestions?

BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes

How does homeowner’s insurance cover belongings? ?

How does homeowner’s insurance cover belongings? ?


I’ve had a term life insurance policy for eight years and it lapsed what can I do?

So I have had a term life insurance for eight years and three months ago my house was robed and my purse went missing. I canceled a lot of bank accounts and opened new ones. my life insurance was one payment that was deducted automatically. well since I canceled my account the payment was not honored for two months. now that I called my insurance company they tell me my policy lapsed and I cannot pay the backed up amounts and continue my policy. Now they want me to get a new one and start all over again. what can I do can they really do that or what are my options???? help it gets expensive since I am older now.


Can anyone answer my question about my auto insurance policy?

okay, last december 2005 I was involved in a minor car accident due to weather conditions, and I had to pay my auto insurance company a 500 deductible” to repair the damages that I made to my vehicle


What is Patient’s Financial Responsibility When Insurance Company Adjusts Claims?

My dental insurance company processed a claim by my dentist and denied it because of their contractual agreement with the provider that any fillings re-worked within 2 years are not the patient’s responsibility. The provider’s benefit statement regarding this service states, “The amounts shown as payable by you and by Delta Dental are in accordance with the terms of your dental plan and the terms of our agreement with your dental provider.” The benefits statement shows my 80% benefit level for this service. The insurance company is not saying that I am ineligible for the benefit. Rather, they are saying that the dentist is not eligible to be paid for this service (by either the insurance company or me) based on his contract with Delta Dental and the benefits to be provided by Delta Dental and paid by the customer. The benefits statements includes notes explaining why the claim was denied. The underlying question is: “What is the patient’s responsibility when the insurance provider says it is zero in accordance with the insurance agreements that all parties are abiding by?” Said differently, “Is the insurance company the final arbiter of amounts owed by the patient?” Does the insurance agreement prevail? Or does the doctor truly have the right to demand payment for amounts that the insurance company says the patient does not owe? I realize the patient is responsible for co-pays and deductibles. But I am pretty convinced that if the insurance company is denying the claim and also stating the patient has no responsibility, then the patient truly has no responsibility until and unless the provider gets the claim processed differently. The provider agreed to be bound by insurance processing when he agreed to accept this provider and its terms and benefits. Insurance companies routinely adjust the “submitted fee” downward to the “accepted/contractual” fee and providers routinely accept those adjustments (and that is one of the reasons we have this complex insurance system: to adjust charges to reasonable levels and protect patients. We pay tons of premiums for this benefit). It makes no sense to then claim the patient owes other amounts that the insurance company says the patient does not owe.

BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes


Looking for universal life insurance..?

I’m looking at Pacific Life for universal life insurance. Is it a good trusted company anyone of u guy familar with? is this company good to invest in. I heard they said their universal life insurance have some pretty good benefit too. Is it true that if my premium is $200/month and with that money, only about $60 went to coverage and $140 go into my saving? is this true?


How much will my car insurance cost?

How much will my car insurance cost?


Can I get homeowners insurance if I am in a part buy part rent property?

I am in a part buy part rent property. Am I eligable for homeowners insurance.


How much would life insurance cost under these circumstances on average?

A 22 year old obese male living in New York State who has never smoked. Seeking a $100,000 Whole Life Insurance policy. What is your estimate based on these numbers.


How much much would my insurance be?

Past suicidal attempt and misdemeanor. 18 Female years of age.


For those that did not buy medical insurance, what fine do they get, and how do they go to the hospital if needed?

For those that did not buy medical insurance, what fine do they get, and how do they go to the hospital if needed?


Car insurance prices?

i’ve just turned 17and i am wondering how much roughly will, lessons theory test and driving test all come too and insurance and also im a girl 🙂


What does basement flooding insurance cover?

i want my ps3,TV,laptop,and other things to be covered if they do not work because of a flood and how much does a plan like this cost?


What is Patient’s Financial Responsibility When Insurance Company Adjusts Claims?

My dental insurance company processed a claim by my dentist and denied it because of their contractual agreement with the provider that any fillings re-worked within 2 years are not the patient’s responsibility. The provider’s benefit statement regarding this service states, “The amounts shown as payable by you and by Delta Dental are in accordance with the terms of your dental plan and the terms of our agreement with your dental provider.” The benefits statement shows my 80% benefit level for this service. The insurance company is not saying that I am ineligible for the benefit. Rather, they are saying that the dentist is not eligible to be paid for this service (by either the insurance company or me) based on his contract with Delta Dental and the benefits to be provided by Delta Dental and paid by the customer. The benefits statements includes notes explaining why the claim was denied. The underlying question is: “What is the patient’s responsibility when the insurance provider says it is zero in accordance with the insurance agreements that all parties are abiding by?” Said differently, “Is the insurance company the final arbiter of amounts owed by the patient?” Does the insurance agreement prevail? Or does the doctor truly have the right to demand payment for amounts that the insurance company says the patient does not owe? I realize the patient is responsible for co-pays and deductibles. But I am pretty convinced that if the insurance company is denying the claim and also stating the patient has no responsibility, then the patient truly has no responsibility until and unless the provider gets the claim processed differently. The provider agreed to be bound by insurance processing when he agreed to accept this provider and its terms and benefits. Insurance companies routinely adjust the “submitted fee” downward to the “accepted/contractual” fee and providers routinely accept those adjustments (and that is one of the reasons we have this complex insurance system: to adjust charges to reasonable levels and protect patients. We pay tons of premiums for this benefit). It makes no sense to then claim the patient owes other amounts that the insurance company says the patient does not owe.

BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes


How much will my insurance give for my totaled car?

I was wondering how the previous accident would factor in on the amount i would get. NADA shows $6550 for average condition. Will the accident before i purchased the car affect my return?


Fastest accelerating car in the insurance group 1-3?

Hello, I am going to be turning 17 shortly and would like some advise on which car that would be very responsive and quick. My budget for the car itself is £1450 but there could be a bit of flexibility. As I am sure you all know, insurance for new drivers is very high, so I want something in between groups one and three as I believe that is the area that I can afford. Could I also please ask for serious answers. I am not not wanting to drive irresponsibly, if that is a worry to some contributors. Thanks.


Denied car insurance?

what happens if all the major car insurance companies deny you insurance if your a first time driver and have bad credit. geico and allstate denied me already. what can i do if they ALL deny me?


Examples of car insurance for 17 year old male in florida?

I plan on staying on my parent’s insurance also


Which Web hosting Should I Pick?

Hello I use .Mac web hosting to host Mac-Fun.com and MacPak.Co.Cc right now. But they dont offer php or any of the good stuff. Yesterday i released a new program and got thousands of downloads. To host my downloads over 50 megabits i use Filefront.com. I released http://files.filefront.com/MacPack+601dmgsitx/;11255626;/fileinfo.html yesterday and got over 1000 downloads (Filefront is a little delayed) and used over 10000 gigs of bandwith. I need webhosting with TONS OF BANDWITH or unlimited. I want to host my files on my own website not filefront. Should i keep hosting my files on filefront and use godaddy or use http://www.webhostingpad.com/? I need a decision helper. Which is better?


G2 Auto Insurance Question!?

Hi, I am currently 16 almost 17 and I just got my G2 license. From the research that i have done I know that I need to have insurance to drive my parents car as a part time driver. I did go to driving school and got the drivers education certificate from CAA. However I am not really sure what to do now because my parents have 2 cars and my grandmother and grandfather have 1 car. I intend to use all 3 cars at different times because my whole family is very busy but i believe that my grandparents have separate insurance. I was wondering if I am going to have to pay to be a part time driver for all 3 cars or how does it work. Either way my dad is going to call the insurance company. Also if I do have to pay what do you think the price would be like and do you have any tip on how to maybe reduce cost?


How much money will I need for health insurance if I retire at 56?

I’m thinking of possibly retiring when I’m 56. I’m 55 now. I have about $60,000 saved for health insurance purposes. I will not be eligible for any tax credits through Obama-Care as I have too much money saved up. Will $60,000 be enough to pay for health insurance till I’m 65?


1 Day Car Insurance?

Any way I can get car insurance for my car for only 1 day? I NEED to take it somewhere for a couple of hours and it NEEDS to be insured. Thanks.

BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes


How much is insurance for a 2005 V6 mustang for a 49 year old women?

My mom wants a mustang for her birthday just to drive back in forth to work. What will the insurence cost for her


Clue less abouts life insurance. help!?

With this whole obama thing going on we obviously need to get life insurance now..my husband and I cannot even afford full price 1bedroom apartment so I dont know where to start..any information and tips would help.


350z insurance cost tx 16year old?

how much is insurance for a 2006 350z for a 16 year old first car in texas?


How can I get Health insurance if I do not make enough to afford it (read details)?

I am 19 , live alone with no help from my parents,and make only minimum wage at a less then full time job(that offers no benefits). I financially pretty much have no way to afford health insurance.I sadly have had to just live with out it. The problem is I’m now trying to go to college for a job in the heath care field ……In order just to enroll for the class you must have proof of health insurance….I’m not sure what to do since there’s just no way I see that I’ll be able to afford it….especially if you have to do a down payment and so forth which is the usual way to start up insurance…..Is there any kind of health insurance that I can get in my situation that is extremely cheap and not a fraud…..I need very very affordable and legitimate health insurance PLEASE HELP!



BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes

How much would it be for insurance on two vehicles if one was a classic?

I live in new york, I am buying a car soon, and i am getting two one is going to be a 1990 GMC Sierra z71 stepside, and the other one is going to be and older car from a 1970-1973, do any of you have a clue how much it would cost a month or would i have to go to an insurance company to do that, if i register the older car under a classic car will it be less then just putting it under a regular car


What is Patient’s Financial Responsibility When Insurance Company Adjusts Claims?

My dental insurance company processed a claim by my dentist and denied it because of their contractual agreement with the provider that any fillings re-worked within 2 years are not the patient’s responsibility. The provider’s benefit statement regarding this service states, “The amounts shown as payable by you and by Delta Dental are in accordance with the terms of your dental plan and the terms of our agreement with your dental provider.” The benefits statement shows my 80% benefit level for this service. The insurance company is not saying that I am ineligible for the benefit. Rather, they are saying that the dentist is not eligible to be paid for this service (by either the insurance company or me) based on his contract with Delta Dental and the benefits to be provided by Delta Dental and paid by the customer. The benefits statements includes notes explaining why the claim was denied. The underlying question is: “What is the patient’s responsibility when the insurance provider says it is zero in accordance with the insurance agreements that all parties are abiding by?” Said differently, “Is the insurance company the final arbiter of amounts owed by the patient?” Does the insurance agreement prevail? Or does the doctor truly have the right to demand payment for amounts that the insurance company says the patient does not owe? I realize the patient is responsible for co-pays and deductibles. But I am pretty convinced that if the insurance company is denying the claim and also stating the patient has no responsibility, then the patient truly has no responsibility until and unless the provider gets the claim processed differently. The provider agreed to be bound by insurance processing when he agreed to accept this provider and its terms and benefits. Insurance companies routinely adjust the “submitted fee” downward to the “accepted/contractual” fee and providers routinely accept those adjustments (and that is one of the reasons we have this complex insurance system: to adjust charges to reasonable levels and protect patients. We pay tons of premiums for this benefit). It makes no sense to then claim the patient owes other amounts that the insurance company says the patient does not owe.


Car insurance getting caught?

What if the car is insured on other persons name and you are driving it. Is it still the same as without insurance?


How can I find cheaper manufactured home insurance?

We pay about $6000 a year (!!!! yeah, I know!!) for our insurance and it doesn’t cover contents, lanai or the pool. It’s forced by the mort. co. because we couldn’t find any. We’ve called brokers and no luck. Help!! Pasco County Florida, on 1.25 acres, no mh park.

BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes


Car ratings for cost of insurance?

rating numbers car insurance companies use for insuring cars and other transportation.


What car should i buy?

hi I’m from the uk. i will be 17 soon and will ned a car because i will be travailing nearly every day and long distance on weekends. i need a cheep reliable car that i will be able to get a cheap insurance quote on. cheers


Accident and no car insurance?

I live in Hawaii and i got in to a one car accident with my two kids. my daughter was flown off to another island with Air Ambulance and was in ICU at Queens Hospital for a two days. Were are all alive and well but im stuck with a 70,000 medical bill. My truck that was in the accident had no car insurance because i just brought it and my children and i are on MedQuest(medical through the state) Please help me on how to get my bill payed for. thank you


What is good individual, insurance dental plan?

What is good individual, insurance dental plan?


When looking at car insurance is the Claims Legal Assistance Service worth it?

When looking at car insurance is the Claims Legal Assistance Service worth it?


Best insurance policy?

Hi there, i am in Indian working in Bahrain. i am working in a small firm with a small salary. i would like to know about a good insurance policy which can cover child education, pension, health insurance and a life insurance all together. can we get all this in one insurance policy? i want to full detail like how much if i pay monthly and what i will get in returns?


Should we have socialist car insurance?

Is it unfair that people pay different amounts for their car insurance? Doesthis constitute discrimination against people who have to pay more? Should we socialise it so that we all pay the same rate? Why or why not? 🙂


How much will my Car insurance go up?

I hit a car in Los Angeles and I have State Farm. The guy I hit drives a range rover and all I did was scratch his driver’s side door. The body shop wants $1200 to repaint the door, which I think is insane. I would pay cash, but $1200 is a lot of money. Does State Farm have accident forgiveness, or will my premium go up if I claim this on my insurance?


How much does motorcycle insurance typically cost in Ontario?

I’m a student and I can’t afford to keep a car, with the gas and insurance costs, and a car is expensive. But a motorcycle I can afford for the warmer months. All i don’t know is insurance prices, so how much is it usually around?

BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes


If someone’s name is on a vehicle title as co-owner” do they have to be added to the owner’s insurance??”

Thanks for all the informative answers – I really appreciate it!! I’m going to leave this question posted for a few more days before choosing best answer” because there are so many conflicting answers


What is Patient’s Financial Responsibility When Insurance Company Adjusts Claims?

My dental insurance company processed a claim by my dentist and denied it because of their contractual agreement with the provider that any fillings re-worked within 2 years are not the patient’s responsibility. The provider’s benefit statement regarding this service states, “The amounts shown as payable by you and by Delta Dental are in accordance with the terms of your dental plan and the terms of our agreement with your dental provider.” The benefits statement shows my 80% benefit level for this service. The insurance company is not saying that I am ineligible for the benefit. Rather, they are saying that the dentist is not eligible to be paid for this service (by either the insurance company or me) based on his contract with Delta Dental and the benefits to be provided by Delta Dental and paid by the customer. The benefits statements includes notes explaining why the claim was denied. The underlying question is: “What is the patient’s responsibility when the insurance provider says it is zero in accordance with the insurance agreements that all parties are abiding by?” Said differently, “Is the insurance company the final arbiter of amounts owed by the patient?” Does the insurance agreement prevail? Or does the doctor truly have the right to demand payment for amounts that the insurance company says the patient does not owe? I realize the patient is responsible for co-pays and deductibles. But I am pretty convinced that if the insurance company is denying the claim and also stating the patient has no responsibility, then the patient truly has no responsibility until and unless the provider gets the claim processed differently. The provider agreed to be bound by insurance processing when he agreed to accept this provider and its terms and benefits. Insurance companies routinely adjust the “submitted fee” downward to the “accepted/contractual” fee and providers routinely accept those adjustments (and that is one of the reasons we have this complex insurance system: to adjust charges to reasonable levels and protect patients. We pay tons of premiums for this benefit). It makes no sense to then claim the patient owes other amounts that the insurance company says the patient does not owe.


Do Australians have a Social Security number or Social Insurance number?

Do Australians have a Social Security number or Social Insurance number?


Is insurance expensive for two cars (one person)?

I have an automatic car right now and I really wanted a manual but not as an everyday driver.One to just work on and drive occasionally. Can i just switch my insurance from one car to the next, instead of paying for two at the same time?


BMW 318i 53 reg, insurance new driver?

Parents may be buyign a new car, how much would it cost to insure a new driver on a bmw 318i 53 reg, about 30000 miles. Insurance would probably be on parents policy, 30+ years no claims, safe driving etc.


I live in California and got a DUI in 2008. I have not driven in 3 years, will I still have high insurance?

My car was totalled when I got a DUI, so I haven’t had a car or car insurance for the last three years. (my insurance dropped me) –Now I finally have a car and need to purchase insurance. Will my insurance still be through the roof?? or will it be lower since I’ve waited 3 years? And do I still need to get a SR22?


3rd party insurance for my cell phone?

i live in the us and have an expensive unlocked cell phone, how can i get insurance for it, like a 3rd party insurer


cheap auto insurance 0 down



















































Connecticut
Is medically needy from medicaid considered health insurance by law?

Is medically needy from medicaid considered health insurance by law? i live in fl and applied for medicaid they gave me and my wife medically needy and our twins medicaid my question is if under the new law that one must have health insurance or be fined, is what has …

Connecticut
I am looking to get a new car. I am currently on moms insurance – please read below?

I am looking to get a new car. I am currently on moms insurance – please read below? I am 26 and purchasing my first new car – I am currently on moms insurance. I will be getting my own insurance. Do you need proof the day you purchase of …

Connecticut
I have my own health insurance. How will these proposed Healthcare reform measures affect me?

I have my own health insurance. How will these proposed Healthcare reform measures affect me? Am I going to have to pay more now? BEST ANSWER: Try this site where you can compare quotes from the best companies : Compare free insurance quotes RELATED: Cheapest Car to Insure on 18 …