Monday, June 7, 2010

Insurance denied as - Unable to identify patient

Unable to identify patient 

Denial Code : CO 31 Claim denied as patient cannot be identified as our insured

This may be due to two things:
(a) the coverage details given in source document may be incorrect and
(b) data entry error.

If this is due to the latter, it may be due to the fact that the operator has entered the patient name or the id # or the insurance company number incorrectly. This is a serious error and we need to find out why the system had failed to track this. We should correct this and resubmit the claim immediately.

If we have entered all the information correctly even though the claim was denied the same then, We need to send the claim along with the card copy and also we need to check the claim submission address which was printed in the back side of the card copy.

However follow up needs to be done to correct the claim and resubmit.


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