What Is a Claim Denial?

A claim denial is when your insurance company refuses to pay for a medical service you've received. The insurer will send you an Explanation of Benefits (EOB) that states the service is denied and provides a reason, such as a lack of prior authorization or a coding error.

Why It Matters

A denial can leave you responsible for the full cost of the service. It is not the final word, however, as you have the right to challenge the decision. Most denials are reversible if handled correctly and promptly.

How Mira Mace Can Help

Fighting claim denials is a core part of what we do. Our advocates are experts at identifying the reason for the denial, gathering the necessary evidence, and managing the entire appeal process to get the decision overturned. We handle the paperwork and phone calls so you don't have to.