When Appealing a Denial Made Because the Carrier Doesn't Believe

question 52

Short Answer

When appealing a denial made because the carrier doesn't believe the services were medically necessary, the medical office assistant should include information:
A)from the patient's medical record.
B)about payment from other carriers in similar cases.
C)about the physician's time spent with the patient.
D)about the patient's benefit plan.

• A)from the patient's medical record.
• B)about payment from other carriers in similar cases.
• C)about the physician's time spent with the patient.
• D)about the patient's benefit plan.

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Definitions:

Discount Rate

In discounted cash flow analysis, this is the interest rate utilized to calculate the present value of cash flows expected in the future.

Net Present Value

A method used in capital budgeting to evaluate the profitability of an investment by calculating the difference between the present value of cash inflows and outflows over a period of time.

Working Capital

The difference between a company's current assets and its current liabilities, indicating the liquidity and operational efficiency of the business.

Salvage Value

The forecasted value at which an asset can be resold once it's no longer useful.