Intro: Denied… Now What?
You went to your massage, physio, or chiro session. You paid. You submitted the claim. And then — the email comes:
❌ “Claim denied.”
Whether it\’s due to a simple paperwork error or a deeper coverage issue, getting a denied claim doesn’t mean the end of the road.
This guide walks you through exactly how to understand, fix, and resubmit your claim — and how to avoid rejection next time.
📬 Step 1: Read the Denial Carefully
Most insurers will tell you why the claim was denied. Look for notes such as:
| Reason Given | What It Means |
| “Missing info” | Your receipt was incomplete |
| “Over benefit max” | You used all your coverage for the year |
| “Ineligible provider” | Therapist not registered/licensed |
| “Service not covered” | Treatment not included in your plan |
| “Duplicate claim” | Already submitted for this receipt |
💬 Not sure what the reason means? Ask Ruby at insurance.rmtclinic.net to translate insurer lingo.
🧾 Step 2: Get the Right Documentation
Depending on the denial reason, you may need:
- A corrected receipt from your provider
- Proof of registration (e.g. therapist license number)
- Doctor’s referral (if required by your plan)
- A signed explanation or appeal letter
✅ Tip: Clinics listed on RMTClinic.net are trained to issue insurance-compliant receipts the first time.
🔁 Step 3: Resubmit the Claim
Most insurers allow re-submission within 90 days of the original service date.
To resubmit:
- Log in to your insurer portal
- Find the denied claim
- Upload the corrected documents or explanation
- Add a short note clarifying the fix
📦 Some plans may also require mailing the paperwork. Ruby can guide you through that.
📌 Step 4: Learn and Prevent Future Denials
Once you’ve fixed the issue, avoid it next time:
- ✅ Ask the clinic before your visit if they provide insurance-friendly receipts
- ✅ Know your annual limits and how much you’ve used
- ✅ Confirm your provider is registered and recognized
- ✅ Get a referral if your plan requires it
- ✅ Keep copies of all receipts and submissions
🧠 What If It’s Still Denied? You Can Appeal
If you believe your denial is wrong:
- Request a written explanation from the insurer
- Ask your provider to support the appeal
- Contact your plan administrator for guidance
- File a formal appeal letter with supporting documents
Most appeals are reviewed in 1–4 weeks.
💬 Need Help Right Now?
Ruby, your virtual insurance assistant at
👉 insurance.rmtclinic.net
…can help you:
- Decode confusing claim feedback
- Check your provider’s status
- Connect you to clinics with billing expertise
- Draft your re-submission or appeal
