State agency ยท North Carolina Department of Insurance, Smart NC
Smart NC: health claim denied (North Carolina)
A North Carolina Department of Insurance program that helps consumers resolve coverage disputes with their health insurance company. The page says there is no cost for its services.
Know before you go
Smart NC helps with disputes between you and your health insurance company. State insurance departments usually cannot help with self-funded employer plans, Medicare or Medicaid, so ask the program on the phone whether your plan is one it can help with. The page invites you to call to talk with staff about the program's services.
- Cost
- No cost to consumers, according to the page.
- Where
- North Carolina
- How to start
- Call Smart NC and describe the denial. The page also has a video explaining the program.
- Phone
- 855-408-1212, as printed on the provider's page
- Have ready
- Your denial letter; Your insurance card; Your plan name and member number
Where this comes from
- Provider
- North Carolina Department of Insurance, Smart NC
- Source we read
- https://www.ncdoi.gov/consumers/health-insurance/health-claim-denied
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- Not displayed
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
Beneficiary and Family Centered Care Quality Improvement Organizations: find yours
The Medicare contractors that handle fast appeals when hospital or other care is ending too soon, and complaints about the quality of care. Each state is assigned to one of two organizations.
From Centers for Medicare & Medicaid Services
- Program or service
California Department of Managed Health Care: Independent Medical Review
California's regulator for managed care plans reviews denials of medical services, emergency payment and experimental treatment through Independent Medical Review. One form starts either a review or a consumer complaint.
From California Department of Managed Health Care
- Program or service
Center for Medicare Advocacy self-help materials
Downloadable self-help toolkits for Medicare denials involving home health care, outpatient therapy and skilled nursing facility care, from a nonprofit law organization. The page describes materials, not a helpline.
From Center for Medicare Advocacy