In the health care industry, the term “ancillary provider” refers to providers who are not the actual treating physicians or hospitals. An ancillary provider could be a lab, imaging company, or medical equipment supplier, to name a few.
When our doctor sends us for these types of services, many times our insurance ID card information does not “follow” the order for the services. For example, if our PCP determines in an office visit that an x-ray is needed, and the x-ray facility is not in the PCP’s practice, the ID card info that we provided when we checked in for our PCP visit is not always sent along with order for that x-ray.
Therefore, we may receive a bill from the x-ray company, saying the claim is not paid. The reason for this non-payment is not always printed on the bill, so we often assume the insurance company has denied the claim, when in fact, the claim was never sent to the insurance company.
We recommend that our customers first call the provider billing office to be sure they have the insurance information on file. If not, the next course of action is to provide all the information on the card (perhaps fax or email a copy of the card to them), and ask them to submit to the insurance company for processing. Once this is done, a new statement should be generated showing the processing of the claim.