Reference no: EM131802114
Match the reason that the insurance claim was rejected with the possible solution to the problem
Proofread numbers carefully from source documents.
Check for Sr., Jr., correct birth date, and verify the insured.
Refer to an updated diagnostic codebook and review the patient record.
Verify with the patient's medical record that all dates of service are listed and accurate.
Verify that the place of service is correct for the submitted procedure code(s) and fill in correct service code.
Refer to the current procedure codebooks and verify the coding system used by the insurance company.
Verify and submit valid modifiers with the correct procedure codes for which they are valid.
Total all charges on each claim, recheck the math, and verify amounts with patient account.
Obtain data from patient during the first office visit on which company is the primary insurer.
Submit all attachments with patient's name and insurance identification number.
A, The insurance claim was submitted to the secondary instead of the primary insurer.
B .Missing place of service code.
C. Patient's name and insured's name are entered as the same when the patient is a dependent.
D. The patient's insurance number is incorrect.
E. Total amounts do not equal itemized amounts charged.
F. Diagnostic code is missing.
G. Incorrect modifier.
H. Operative report is missing from the insurance claim.
I. Duplicate dates of service listed.
J. Procedure code is invalid.