What can happen if a provider does not supply the necessary information to the insurance company?

If a provider does not supply the necessary information to the insurance company, the claim may be denied with a requirement to resubmit. This occurs because insurance companies rely on a complete set of information to determine the medical necessity and appropriateness of services provided. Without the required details, the insurance company cannot process the claim effectively, leading them to deny it. The provider is typically responsible for ensuring that all pertinent information is submitted upfront; if this does not happen, they will have to address the denial and gather the necessary documentation to resubmit the claim for reconsideration.

This understanding reinforces the importance of thorough communication and submission practices between healthcare providers and insurance companies. The other options do not accurately reflect the standard protocol when insufficient information is submitted. For instance, claims are not typically accepted with minimal information, nor do they automatically go to appeal; instead, they usually face denial initially. Furthermore, while insurance companies may communicate with patients in some contexts, they primarily deal with providers regarding claims and required information.