commercial health insurance company reviewed patient records as part of the claims payment process and then denied payment for submitted procedures and services totaling $7,000. The insurance company's denial letters stated that documentation about denied procedures and services were not found in the patient record. What action should the provider's office take?

Respuesta :

The action the provider's office should take will be to conduct

an audit and confirm if it was documented.

What is Insurance?

This is a contract in which the individual receives financial

protection against losses.

There is a statement which says "if it is not documented, it did

not happen" which is why the provider's office should perform

audits and confirm if there was any form of documentation. In

cases  where there was, the officer will have to reimburse

the $7,000 to the patient.

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