Voice-mail Procedure & notes format?
Why is a proper voice mail needed? A good voice mail will make the payer rep call us back with
Read More
Claim denied for Prior authorization
Meaning: The insurance does not find authorization for the treatment denied. Claim Adjustment and Remark Codes: CO197 Precertification/authorization/notification absent. CO198
Read MoreDuplicate Denial Scenario
Meaning: The claim submitted has already been processed by the insurance. A similar service was performed for the same patient
Read MoreClaim Timely Filing Limits:
Sl.No Payer TFL Corrected Claim Filing Limit Appeal Filing Limit 1 AETNA 120 DAYS FROM DOS 180 DAYS FROM DOD
Read MoreEOB Calculation Formulae
Billed Amount = Allowed Amount + Contractual Adjustment Allowed Amount = Paid Amount + Patient Responsibility Patient Responsibility = Coinsurance
Read MoreMOCK CALL-DX code is inconsistent with the CPT code
James is AR CALLER Calling from India to USA insurance live rep in order to check the claim status the
Read MoreMock Call-Non-Covered service.
James is AR CALLER Calling from India to USA insurance live rep in order to check the claim status the
Read MoreUSA Social System
Social Security Number (SSN) SSN is the 9-digit number given by the Federal Government through the Social Security Administration (SSA)
Read MoreAR CALLERS NOTES FORMAT
1. Claim is SET TO PAY: DOS 11/06/2020 as per review found the claim was submitted on 11/10/2020 and no
Read MoreMOCK CALL-Authorization Scenario
James is AR CALLER Calling from India to USA insurance live rep in order to check the claim status the
Read More