If a Claim Is Denied Because Additional Information Is Needed

question 31

Multiple Choice

If a claim is denied because additional information is needed to prove medical necessity, the medical office specialist should:

• A) bill the patient.
• B) write off the entire amount.
• C) ask the patient to write a letter explaining the situation.
• D) submit the required information and follow up with the carrier.

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Definitions:

Routine Specimen

A sample of bodily fluid or tissue collected under standard conditions for medical testing.

Clean Catch Specimen

A method of urine collection that aims to minimize microbial contamination from the external genitalia.

Incontinence

The inability to control the excretion of urine or feces, leading to unintentional loss of bladder or bowel control.

Water Pills

Medications that increase urination to help reduce fluid retention in the body; also known as diuretics.