1. Why was my claim denied?
- Response:
- “Let me check your EOB for the exact reason—common issues include missing information or needing prior authorization.”
- Offer to re-file or appeal if appropriate.
2. This charge is higher than I expected.
- Response:
- “Your plan may have a deductible or coinsurance. Here’s the breakdown…”
- Show the EOB and compare it to their policy benefits.
3. I can’t afford this bill.
- Response:
- “We offer payment plans or financial assistance—let’s find an option that works for you.”
- Provide a simple payment agreement (e.g., $50/month).
4. I already paid this!
- Response:
- “Let me verify your payment. Sometimes delays happen between our system and your bank.”
- Share a receipt or adjust the balance if duplicate.
5. What’s this extra fee for?
- Response:
- “This covers [specific service/supply]. Here’s why it’s necessary…”
- Example: “The $25 fee is for your annual wellness visit paperwork.”
