Hello darsben1,
As previously stated each disablement is handled on a case by case basis. In some examples the provider may make an error and charge for an eligible portion of the service. In those cases the member would submit for consideration of reimbursement and the eligible amounts would be reimbursed.
Please keep in mind that these type of issues take place on less than 1% of our service requests.
Thank you,
Ella
Good Sam Care Team