Denial in Medical Billing
A denial in medical billing occurs when an insurance company refuses to pay for a healthcare service, either partially or in full.
Denial in Medical Billing Explained
In medical billing, denials happen when claims are submitted with errors, incorrect codes, or if the insurance company deems the service medically unnecessary or outside of coverage. Denied claims can be appealed, and providers often need to provide additional documentation to resolve the issue.
For example, a claim for physical therapy might be denied if the insurance company considers the therapy unnecessary or if prior authorization wasn’t obtained.
Check acronyms and abbreviations in Medical billing glossary.
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