Medically Not Necessity Denial
Medical necessity is defined as accepted health care services and supplies provided by healthcare entities appropriate to evaluating and treating
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What is Ambulatory Surgery (ASC)?
Outpatient surgery or surgery that does not require an overnight hospital stay (more than 24 hours). Other names Day surgery
Read MoreMOCK-CALL_DEDUCTIBLE
Sandy: Thanks for calling this is Sandy how may I help you today? James: Hai my name is James I
Read MoreVoice-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 MoreDuplicate Denial Scenario
Meaning: The claim submitted has already been processed by the insurance. A similar service was performed for the same patient
Read MoreARCALLING 49 DENIAL SCENARIOS
1. Patient not on file or Patient cannot be identified as our insured (Adjustment reason code: 31) Check with the
Read MoreInterview Questions
1. Ambulatory Surgery (ASC)? Outpatient surgery or surgery that does not require an overnight hospital stay (more than 24 hours).
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