Follow-Up Support: What a “Follow-Up Action” Does NOT include
- Help understanding how the claim was processed and if there are any next steps that need to be taken to complete the case is NOT considered follow up. If you need help with these please use the Explanation of Benefits Request on the website if you have received statements/updates from your insurance.
- Updates on the claim status are NOT considered follow up. If you need an update on the claim status, please use the Timely Service Request on the Website.
Follow-Up Support: What a "Follow-Up Action" DOES include:
A follow-up action includes one or more of the following activities performed after claim submission:
- Having our office call the insurance company for any reason related to claim processing, including claim status.
- Contacting insurance about payments, lost checks, incorrect payee, misdirected payments, or payment processing questions.
- Submitting medical records or documentation needed for claim processing
- Addressing issues related to provider registration, payer system requirements, or plan administration when claim processing depends on additional provider/practice information
- Providing support for an appeal. This includes letter templates, claims/billing/coverage details that would support an appeal, plus any other items you might need help with for an appeal.
Note: Formal insurance appeals are not included in billing services and are the responsibility of the patient. If you would like support for an appeal, please use this form and we will send you information and templates for submitting an appeal.
Follow-Up Cap Details (Important)
Billing services include a maximum of two (2) follow-up actions after claim submission.
EOB explanation does not count as a follow-up action and is provided as an informational service to help patients understand how their claim was processed.
Once two follow-up actions have been completed, additional follow-up support is not included unless separately arranged.
After the Cap: Options for Additional Support
If a claim requires continued work beyond the included follow-up support, patient takes over-
If you have reached the cap on follow up requests, you can still complete this form and Lyons Medical Billing will provide guidance on what to do next, including step by step guides, and provide claim reference information when available.