Start with facts
Do not begin by assuming the bill is wrong. Identify exactly what differs and which organization controls that part of the process.
Common issues to investigate
- Insurance was not billed
- Wrong insurance information
- Claim still pending
- Out-of-network processing
- Duplicate charge
- Payment not posted
- Service/date/provider mismatch
- Authorization issue
- Coding or claim correction needed
- Estimate excluded a separate biller
Who to contact
Provider billing office
Charges, itemized statements, payments, coding review requests, and payment arrangements.
Insurance plan
Claim processing, benefits, network status, denial reasons, and appeal instructions.
Care team office
Clinical documentation or authorization coordination when relevant.
Other biller
Independent lab, imaging, anesthesia, pathology, or other separately billing organization.
Document the conversation
- Date and time
- Organization
- Representative name or ID
- Reference number
- What was explained
- What will happen next
- Expected follow-up date
These public guides are structured so verified provider, insurer, price, availability, and customer-authorized data can later be inserted from the CareAnything database and APIs without changing the customer journey.