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Disallowance

The denial of a claim by your insurance company, meaning they will not pay for the service.

Detailed Explanation

A claim might be disallowed for various reasons, such as the service not being covered, lack of pre-authorization, or incorrect coding.

Practical Example

Mark received a notice from his insurance company that his claim for a certain medical procedure was disallowed because it was deemed not medically necessary according to their guidelines.

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