Author Question: If a service is not likely to be covered by a beneficiary's Medicare benefits, the provider must ... (Read 35 times)

WhattoUnderstand · **on:** Jun 27, 2018

If a service is not likely to be covered by a beneficiary's Medicare benefits, the provider must issue the patient a(n):

a. invoice for monies due.
b. Advance Beneficiary Notice.
c. written explanation of denial.
d. copy of the Medicare contract.

Question 2

If you disagree with a Medicare decision, what is the recourse?

a. Submit a complaint to the complaint department.
b. Call and discuss the matter with the claims administrator.
c. Appeal the decision in writing on the appropriate form.
d. Send a letter asking for better reasons for denial.