Question

When an insurance carrier has denied payment for a procedure that did not get prior authorization, the service

a. Can be billed to the patient for the full fee.
b. Will be paid at 50% by the insurance carrier.
c. Is written off by the provider.
d. Is paid 20% by the patient.

Answer 1

When an insurance carrier denies payment for a procedure that did not get prior authorization, the service is typically billed to the patient for the full fee.

Step-by-step explanation:

When an insurance carrier has denied payment for a procedure that did not get prior authorization, the service is typically billed to the patient for the full fee. This means that the patient is responsible for paying the entire cost of the procedure out of pocket. The insurance carrier does not contribute any payment towards the procedure since it was not authorized beforehand.