Insurance Management FAQs

I am new in practice and submitted a claim to an insurance carrier four weeks ago, but have heard nothing. Is this common?

Most insurance carriers pay "clean" claims within 30 days. A clean claim is generally a claim that does not require radiographs or other supporting documentation. Under Pennsylvania’s Prompt Payment provision, insurers and managed care plans “…shall pay clean claims and the uncontested portions of a contested claim…within 45 days….” Fines are levied if this provision is not met. If you have not heard from the insurance carrier within this time constraint, contact them and request status.

Answer is informational only and not intended as legal advice. Answer may contain excerpts from The ADA Practical Guide to Frequently Asked Legal Questions.