Denial reason group 6

Your insurance company has denied your claim for the following reasons:

  • Charges exceed your contracted/legislated fee schedule
  • Usual and customary reductions (UCR)

Steps you should follow to appeal insurance denials:

  • Contact your insurance company to verify if Mayo Clinic is contracted and in network with your policy.
    • If yes, request that your insurance company reprocess the claim and pay per the contract with Mayo Clinic.
    • If no, did you need/obtain a referral?
      • If yes, ask your insurance company to reprocess the denied charges.
      • If no, ask your primary care physician to submit a referral authorization.
    • Was your service provided in an emergency room? If so, contact your insurance company to review your policy for emergency care coverage.