5
out of 5
POSTED: | BY: Carol
Had to contact a supervisor to correct an error
Several times in the past couple of yearsI have submitted a claim and it was denied saying you had to have documentation for this. You had documentation for it already. I had to contact a supervisor to look up the information and confirm that indeed you had what you needed. This particiular problem I've encountered several times. All someone has to do it look at the history - it took the supervisor about 30 seconds to look at it and tell me yes, we do have all the information, I'll send it in for reprocessing. I submitted one claim for her ACL tear medication several months ago and it was denied because they put it down as arthritis, not the ACL tear. The claim form said it was for ACL tear and someone was careless about even reading my accompanying letter. Do you even look at the accompanying letter of explanation? Should I not bother to even send one? Other than these particular problems, we don't have any others. But I have to keep looking at the EOBs to be sure they weren't denied because of error on the part of someone at Nationwide.