Why Delay? Claim may not be for a covered contract benefit Patient's preexisting condition is not covered or patient coverage has been cancelled Case is under consideration as Workers' compensation (WC) is involved Payer considers the physician's procedure experimental Preauthorization for a procedure or for hospitalization was not obtained Services were provided prior patient's health insurance contract went into effect Payers may ask for additional information Payer has requested information about another carrier for coordination of benefits
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