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Reload this Page My M.D. won't re-submit my insurance claim

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  #1  
Old 03-21-2009, 07:19 PM
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Join Date: Mar 2009
Posts: 1

My M.D. won't re-submit my insurance claim

What is the name of your state (only U.S. law)? CT
My dermatologist refuses to re-submit a claim to my secondary insurance. Medicare denied the claim his office sent without a diagnosis, he stated "elective surgery" for a diagnosis. My secondary insurance, a fee for service, also denied it and said it lacked a diagnosis. The dermatologist said he cannot legally re-submit it and I will have to pay the full cost. My question: Since no diagnosis was given, do I have a legal right to demand that a diagnosis be given? Can I demand that he re-submit the claim to my secondary insurance carrier who does cover the procedure?
  #2  
Old 03-22-2009, 01:26 AM
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Location: Philadelphia, PA
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WAS it elective surgery?
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  #3  
Old 03-22-2009, 11:59 AM
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Pay the provider and submit the claim yourself. If it's covered, you will be reimbursed as per your agreement with the ins. co.
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  #4  
Old 03-22-2009, 12:58 PM
cbg cbg is offline
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Legally, the doctor has no obligation to submit the bill AT ALL unless he has a contract with the insurance carrier to do so. You have no legal grounds to "demand" anything.

Agree with Zigner.
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