Reimbursement Methodologies

posted by .

You work for a third-party payer performing medical records review. Your job is to match codes that were submitted on the claim to documentation in the medical record. You notice that a code has been input for a colonoscopy precedure, but you don't see the procedure report anywhere in the record. As the third-party payer representative, what will your action be reguarding the code that was submitted on the claim form?

I would go back to whomever input the code and make sure they used the right code. Am i anywhere close to where i need to be?

  • Reimbursement Methodologies -

    I think you're right.

Respond to this Question

First Name
School Subject
Your Answer

Similar Questions

  1. Health

    You work in the hospital's health information management department. Part of your job is to assist the medical residents with completing records documentation. One of the residents complains that he doesnt understand why insurance …
  2. medical billing and coding

    you work for a third party payer performning medical records review. your job is to match codes that were submitted on the claim to documentation in the medical record. you notice that a code has been input for a colonoscopy procedure, …
  3. reimbursement methodologies

    you work for a third party payer performing medical records review, your job is to match codes that are submitted on the claim form to documentation in the medical record. the code has been inputed but you don't see the procedure report …
  4. reimbursement methodologies

    you are a third-party payer performing medical records review your job is to match codes submitted to claims , you see a code for a colonoscopy procedure but you don't see the procedure report anywhere in the record , as athird-party …
  5. coding

    you are a third party payer performing medical record review you notice a procedure that was not done what should you do
  6. health

    You’re an HMO director. You would like to ensure that you managed care plan is meeting industry standards. What’s one way that you can do this?
  7. Reimbursement Methodologies

    You work in a physicians office performing billing. You notice that the guidelines haven't been followed accurately in completing the claim form. What will happen if you don't correct the claim form ?
  8. Reimbursement Methodologies

    I have done my research for the following questions but I was hoping someone could check and tell me how I did. Part A: Answer each of the following questions in a short paragraph. 1. You're the new director of a hospital health information …
  9. Reimbursement Methodologies

    You work in the hospital information Management, part of my job to assist medical resident with completing the record documentation.
  10. ICD9

    All ICD9-Cm Codes must be supported by: A. Nonessential modifiers. B. physician documentation in the medical record. C. V codes. D. another diagnostic code.

More Similar Questions