f.a.q.

You have questions. wE have answers.

Please contact us in case you do not find an answer to your question.

Q. The patient has coverage through us, will you deal with us the insurer?

A. Yes, please send us the coverage/benefit details (VOB, LOG) and a list of documents you need from the provider and patient and we will deal with you directly.

Q. How can we obtain documents we need from the medical provider to process the claim?

A. Please send us the list of documents you need from the provider and we will send those to you.

Q. We have denied the claim, what documents do you need from us?

A. Please send us an explanation of benefits or a denial letter detailing the reason for the denial and the appeals process. Please also ensure you have communicated the denial reasons to your insured.

Q. Why does the provider keep referring us back to OVAG?

A. OVAG deals with the provider’s international accounts under different scenarios, we are considered an extension of the billing office or international department. Everything you need to request or communicate should therefore come through us to deal with.

Q. What is an uninsured discount and why aren’t we the insurance allowed to pay the uninsured rate?

A. An uninsured discount (self-pay discount) is a reduction only given to patients that meet specific criteria in certain legal jurisdictions; the main condition being that the patient does not have any insurance coverage. Insurance companies are not granted uninsured discounts for this reason.

Q. We sold the insurance policy but use another company to process the bills, they are not able to resolve the matter, what can we do?

A. We often encounter situations where assistance companies and Third Party Administrators (TPAs) do not have agreements with providers and cannot resolve claims. This unfortunately causes patients to be billed and avoidable complaints from providers and patients. Send us the information about the claim and we will provide you with a full status of the situation in order for you to confirm what steps you plan to take to resolve the matter.

Q. We have not been able to speak to someone at the provider’s office. Can you help us resolve a bill?

A. Yes, please send us the information you have, what you need in order to process a payment and we will clarify what the situation is to resolve the matter quickly.

Q. We had an agreement to pay a medical bill for one of our insured, however, the patient is now being asked to pay the balance, why is that happening?

A. Agreements have specific requirements, when those terms are not met the agreements are considered invalid and the full amount has to be paid. Please send us a copy of the agreement or any information you have available and we will review the details.

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