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Author Question: If the reported services are deemed NOT medically necessary at the level reported, the claim will ... (Read 277 times)

Jipu 123

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on: Jun 27, 2018
If the reported services are deemed NOT medically necessary at the level reported, the claim will be:
 
  denied.
 
  downcoded.
 
  upcoded.
 
  pended.

Question 2

An audit/edit report from a clearinghouse will show all of the following EXCEPT:
 
  claims that need corrections.
 
  claims that are missing information.
 
  claims forwarded to the insurance carrier.
 
  paid claims.
Comprehensive Health Insurance: Billing, Coding, and Reimbursement ¦ Vines, Braceland, Rollins, Miller ¦ 3rd Edition
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raenoj

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Reply #1 on: Jun 27, 2018
Answer to Question 1

Answer: downcoded.

Answer to Question 2

Answer: paid claims.


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