Appointments and referrals
Getting a referral and keeping it from expiring before the visit.
Many plans want a referral or an approval before you see a specialist, and some approvals end on a set date or cover only a set number of visits. Missing one of those details is a common reason a visit is billed as not covered.
These guides cover who asks for the referral, what to confirm with the insurer and the specialist's office, and how to keep track of dates so the approval is still good on the day you are seen.
Pages that cover this topic
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Walk-through checklist
Prior authorization checklist for patients
A before, during and after checklist for getting an insurer's approval before a planned test, procedure or treatment.
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Step-by-step guide
How to read an explanation of benefits (EOB)
What each part of an explanation of benefits means, and how to check a provider's bill against it before you pay.
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Step-by-step guide
Appealing a denied health insurance claim
The general path for appealing a denied claim, from reading the denial letter to an internal appeal and then external review.
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Try-it tool
Out-of-pocket estimator
Estimate what you may owe for one covered service. It is an estimate, and your EOB is what counts.