« previous next »

Author Question: If the reported services are deemed NOT medically necessary at the level reported, the claim will ... (Read 171 times)

Jipu 123

  • Hero Member
  • *****
  • Posts: 569
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
Buy Test-Bank


raenoj

  • Sr. Member
  • ****
  • Posts: 340
Reply #1 on: Jun 27, 2018
Answer to Question 1

Answer: downcoded.

Answer to Question 2

Answer: paid claims.


Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
« previous next »
 

Did you know?

Certain chemicals, after ingestion, can be converted by the body into cyanide. Most of these chemicals have been removed from the market, but some old nail polish remover, solvents, and plastics manufacturing solutions can contain these substances.

Did you know?

Children of people with alcoholism are more inclined to drink alcohol or use hard drugs. In fact, they are 400 times more likely to use hard drugs than those who do not have a family history of alcohol addiction.

Did you know?

Multiple sclerosis is a condition wherein the body's nervous system is weakened by an autoimmune reaction that attacks the myelin sheaths of neurons.

Did you know?

One way to reduce acid reflux is to lose two or three pounds. Most people lose weight in the belly area first when they increase exercise, meaning that heartburn can be reduced quickly by this method.

Did you know?

All adverse reactions are commonly charted in red ink in the patient's record and usually are noted on the front of the chart. Failure to follow correct documentation procedures may result in malpractice lawsuits.

Mechanisms of pain at the nociceptor level Mechanisms of pain at the nociceptor level
Language Access Services Language Access Services
Entry level nurse competencies Entry level nurse competencies
Instructions for Completing the CMS-1500 (02/12) Claim Form Continued Instructions for Completing the CMS-1500 (02/12) Claim Form Continued
CPT Modifiers Used for Medical Office Services CPT Modifiers Used for Medical Office Services
Ecosystem goods and services and monetary values Ecosystem goods and services and monetary values
Video: Cardiac Cycle (Part 2 of 4)

For a complete list of videos, visit our video library