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CLAIM DENIALS
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A POST SERVICE DENIAL CAN BE TAKEN OVER THE PHONE. TRUE OR FALSE?
FALSE
WHAT OTHER SCREEN CAN YOU LOCATE DENIAL CODE AND REASON?
RF0300
WHAT TWO PLACES CAN YOU LOCATE A MEMBERS APPEALS RIGHT FROM A CLAIM DENIAL
FROM DENIAL LETTER OR KMT
When receiving denial Ex code 25, what is the appropriate/corresponding advice?
USED WHEN MEDICAL JUSTIFICATION IS REQUIRED BUTNOT PROVIDED. ADVISE PROVIDER TO SUBMIT OFFICE NOTES/MEDICAL RECORDS
WHAT IS THE DENIED AMOUNT FOR CLAIM 221229M23211?
76.03
What denial ex code is associated with message: EXCEEDS PLAN GUIDELINES,CONTRACTING PROVIDERS DO NOT BILL MEMBER?
EX 56
What message is associated with denial code Ex 08?
PRIMARY INSURANCE EOB REQUIRED FOR PAYMENT CONSIDERATION
WHAT IS THE REASON FOR DENIAL CODE EXIL?
INPT.ADMISSION NOT PRIOR APPROVED,CONTRACT PROVIDER DO NOT BIL
WHAT DOES CT AT THE END OF THE DENIAL LINE REPRESENT IN THE EOP/EOB SCREEN
COTIVITI
WHAT SCREEN DO YOU USE TO FIND THE DENIAL CODE REASON
EOB/EOP MSGS


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