My insurance is refusing to process my claim because my provider won’t submit a w9 form. They’ve already sent them a super bill that contains their NPI and tax ID on it and they don’t see the point in also providing a W9 so they are refusing. What are my options at this point? UHC won’t budge without the w9. Kindly help! I don’t know what else to do! Also the provider is out of network
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It’s common for insurers to request this before adding a new provider to their system. It helps verify the business, even though tax info isn’t needed in this case.
Years ago, an out-of-network massage therapist refused to provide one, so a member couldn’t get reimbursed. The member kept pushing for it (and rightfully so), which led to the discovery that the massage therapist didn’t have a license.
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Wow so should I keep pressing my doctors office to give me one? They provided their NPI and Tax ID on the superbill.
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I’m assuming this is out of network?
Submit the claim so the payment goes to you, not the provider.
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An out-of-network provider isn’t required to give you a W-9. It’s your responsibility to check what UHC needs to reimburse the claim.
This is why most people stick with in-network providers.
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They never mentioned the w9 until now. They only said superbill at first which I got from my provider.
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There’s a difference between an out-of-network provider and a self-pay provider. If the provider truly didn’t want to cooperate with potential insurance requirements, the provider should not have given the superbill.
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There’s zero difference. If the provider is not contracted, they’re not obligated to provide you with carrier assistance.
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They need that information to add the provider to their system, which doesn’t make much sense. But they won’t process my claim without it. They also said it’s how they verify the business.
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Yes, they need to verify you saw a real doctor and didn’t make it up. I’m not saying you’re making it up, but people can fake or alter bills. It’s like when a bank asks for ID to cash a check—they want to confirm it’s you. Insurance wants to make sure your provider is legitimate, not someone unqualified or shady. (Again, not saying you did that.)
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Yes but that information is already on the superbill. Their NPI and tax ID.
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Why not create it yourself? It’s just name address tax ID which seemingly you already have the majority of the info.
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The form also needs to be signed by them.
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Create the form bring it to the office ask for signature submit to insurance they literally wouldn’t have to do anything labor intensive.
Or tell insurance to void claim and submit yourself for reimbursement
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The claim I’m filing is for myself. The provider is paid in full already which is why they don’t want to provide the w9 form. I’m trying to get reimbursed from the insurance company
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Oh, I understand now—sorry for the confusion! When you filled out the bill, did you enter their tax ID or your SSN? I suspect you entered theirs, which is why they want a W-9. In my experience, that field is usually for your TIN/SSN so you can be paid directly.