Friday, August 20, 2010

Insurance denial and action - REQUESTED INFORMATION FROM PATIENT


Action:     Sometimes carriers may want some information from the patient before processing the claims.  This information may pertain to updating of the other coverage’s available to the patient (Coordination of Benefits) or any other reason.  The carrier would not process the claim unless the patient sends the required information. If you get this rejection, need to check with the patient whether he has sent in the required information. If yes, then the claim has to be resubmitted. If no, we have to request the patient to do the same immediately.  Check after a week or 10 days for any update from them, if the carrier has received the requested information from the patient then mention in the comments column that the claim has to be re-filed but if the patient has not sent any information to the carrier then mention in the comments column that the patient has to be billed.  

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