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Friday, June 11, 2010

Claim denied as Invalid diagnosis code


Employer’s name and address is requested if the coverage is Workmen compensation, if the coverage of the patient/subscriber is through the employer, other than w/c cases. For the workmen compensation claims we need to give the information about employer as the coverage is through them.  There are other cases where the patient may have coverage through carrier.  Big corporations like General motors, Ford etc. provide medical coverage for their employees through health insurance carriers. By virtue of being an employee of this company, a person gets benefits of free medical coverage for him and his family.

    Action: If you get this denial, check the PD sheet for employer details. If the same is available but not entered in the system, then enter the details into the system. If no detail is available in PD then call the patient and get the details from him or from the employer if his phone# is available.

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