INSURANCE CLAIMS
& REIMBURSEMENT
Understanding How
Insurance Claims Are Managed
This practice operates independently of private insurance companies. Services are paid directly by the individual at the time of the appointment, and receipts are provided for potential reimbursement where eligible under your insurance plan.
Because every insurance policy is different, reimbursement decisions are made solely by your insurance provider according to the terms and conditions of
your individual coverage.
WHO IS RESPONSIBLE
FOR THE CLAIM
Understanding Each Party’s Role Can Help
Clarify The Reimbursement Process
THE PRACTICE
Antonio provides
– Detailed receipts for eligible services
– Supporting documentation
– Information to identify services provided
Antonio doesn’t submit insurance claims, communicate with insurers regarding claim decisions, or determine insurance eligibility or reimbursement.
THE POLICYHOLDER
The policyholder is responsible for
– Confirming your insurance coverage
– Submitting your claim to your insurer
– Providing documentation to insurer
– Following your insurer’s review process
THE INSURANCE PROVIDER
Your insurance provider determines
– Whether service is covered by the policy
– The amount eligible for reimbursement
– Whether documentation is required
– Any limitations, exclusions, deductibles,
or annual maximums that may apply
WHY MIGHT
A CLAIM BE DENIED
Insurance claims may be denied or only partially reimbursed for a variety of reasons, including:
– Service is not included within the policy
– Plan doesn’t recognize provider / service
– Annual or lifetime benefit limits reached
– Physician referral / prescription required
– Additional documentation requested
– Processing errors occurred
A denied claim does not necessarily mean the service was inappropriate or that reimbursement is unavailable. In some situations, additional information or clarification may resolve the issue.
WHAT SHOULD I DO
IF MY CLAIM IS DENIED
If your claim has been denied or only partially reimbursed, consider the following steps
– Review claim decision
– Contact insurer to request clarification
– Confirm documentation requirements
– Review policy to understand coverages
– Follow insurer’s appeal process if you
believe the claim should be reconsidered
Because every insurance policy is unique, questions regarding reimbursement are best directed to your insurance provider.
NEED TO VERIFY
PROFESSIONAL STATUS
If your insurance provider requests
confirmation of Antonio’s professional
credentials or organizational affiliation,
verification is available below.
Antonio M. Colasurdo is a Pedorthist
and Osteopath specializing in
foot and lower limb function.
Antonio Colasurdo is not a physician and is not registered with the
College of Physicians and Surgeons. He does not provide medical
diagnoses or medical treatment. Advice and services provided do
not replace assessment, diagnosis, or care from a licensed
physician or other regulated health professional.
Antonio Colasurdo 