Understanding ACA Insurance Billing Disputes: Resolving the Issue of Unpaid Covered Sessions

If you’ve ever had an insurance billing issue, you know how frustrating it can be. When the healthcare provider that you’ve been seeing for years suddenly sends you a bill for sessions that you thought were covered by your insurance, it can be a shock. If you’re faced with such a situation, take a deep breath and know that you’re not alone. Many people have encountered similar problems.

The Problem with Unpaid Covered Sessions

One of the most common insurance billing issues is when a provider claims that you were uninsured during a period when you actually had coverage. This can happen for various reasons, such as a mistake on the provider’s end or a lapse in coverage that you were unaware of. As a result, you may receive a bill for sessions that you thought were covered by your insurance.

Resolving the Dispute

If you receive a bill for sessions that you believe were covered by your insurance, the first step is to contact your insurance provider. They can verify your coverage dates and help you determine if the provider made an error. If the insurance company confirms that you were covered during the period in question, you should contact the provider and explain the situation.

Your Rights under the ACA

The Affordable Care Act (ACA) provides several protections for consumers when it comes to health insurance billing. One of these protections is the right to dispute billing errors. If you believe that you have been billed incorrectly, you can file a complaint with your insurance company or the state insurance department.

Steps to Take

If you are having an issue with unpaid covered sessions, here are some steps you can take to resolve the dispute:

Contact your insurance provider. Verify your coverage dates and determine if the provider made an error.
Contact the provider. Explain the situation and provide proof of your insurance coverage.
File a complaint. If you are unable to resolve the issue with the provider, you can file a complaint with your insurance company or the state insurance department.

Conclusion

Insurance billing issues can be frustrating, but they can be resolved. By understanding your rights under the ACA and taking the necessary steps to dispute billing errors, you can protect yourself from being forced to pay for sessions that were covered by your insurance.