Claims processed wrong · Patient responsibility · Payer disputes
The insurer got it wrong.You got the bill.
A claim gets coded wrong, run out-of-network, applied to the wrong deductible or bounced between two insurers, and suddenly the provider says it’s “patient responsibility.” That’s an argument with your insurance company, and you shouldn’t have to have it alone.
Red flags
Signs they’re playing games.
- An explanation of benefits that doesn’t match the care you got
- In-network care processed as out-of-network
- Deductible, copay or coinsurance applied wrong
- Two insurers each saying the other one should pay
- A provider billing you while your insurer “reprocesses”
- For doctors, clinics and facilities: denials, down-coding, slow pay or take-backs on claims you were owed
What we do
How we fight it.
- 01
Line up the bill, the explanation of benefits and the policy, charge by charge
- 02
Force a written reprocessing or appeal with the insurer
- 03
Keep the provider and collectors off you while the insurer’s error is fixed
- 04
For providers: challenge payer denials, underpayments and recoupments under the contract and the law
Questions
Insurance Billing Disputes, answered.
My provider says insurance denied it, so I owe it. Is that true?
Not always. If the denial is the insurer’s mistake or isn’t allowed under your plan, the fight is with the insurer, and you may not owe the bill.
What is an explanation of benefits (EOB)?
The statement your insurer sends showing what was billed, what the plan allowed, what it paid and what it says you owe. It’s the first document we look at.
Do you work with doctors and clinics too?
Yes. Providers fight insurers over denied, underpaid and clawed-back claims. Tell us about the payer and the claims involved.
Also
Other fights we take.
Medical & Hospital Bills
Bills full of errors, duplicate charges and prices nobody agreed to.
Fight it
Surprise & Balance Billing
Emergency care, an out-of-network doctor you never chose, a bill you were never warned about.
Fight it
Hospital & Medical Liens
A lien eating your injury settlement before you see a dime.
Fight itFree case review
Tell us about your insurance billing disputes dispute.
A few sentences is enough to start. We’ll review it and contact you.