What Should Be Done If an Insurance Company Denies a Service

question 45

Multiple Choice

What should be done if an insurance company denies a service stating it was not medically necessary and the physician believes it was?

• A) Rebill with a letter of explanation from the physician.
• B) Write-off the amount on the patient's account.
• C) Send the patient a statement with a notation of the response from the insurance company.
• D) Appeal the decision with a statement from the physician.

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Definitions:

Retroperitoneal

An anatomical term that means behind the peritoneal cavity. It is where the kidneys lie.

Peritoneal Cavity

An abdominal space that lies between the parietal peritoneum (lining of the abdominal wall) and the visceral peritoneum (covering of the internal organs).

Renal Sinus

The renal sinus is a cavity within the kidney that is occupied by the renal pelvis, renal calyces, blood vessels, nerves, and fat.

Hilum

A part or structure in an organ where nerves and blood vessels enter or leave, commonly referenced in relation to the lungs or kidneys.