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.

Comprehend how socioeconomic status affects health symptoms, health reporting, and likelihood of seeking medical care.

Recognize the impact of the symptomatic characteristics defined by David Mechanic on healthcare-seeking behavior.

Identify the components of illness conceptualization as described by Howard Leventhal, including cause, identity, consequences, timeline, and control.

Relate illness conceptualization and the decision-making process regarding seeking medical care in various demographic contexts.

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Definitions:

Short Run

A period of time in economics during which at least one input, usually capital, is fixed and cannot be changed.

Efficient Output

The level of production at which a company or economy can produce the maximum amount of goods and services with the least waste of resources.

Profitable Output

The level of production at which a business or economic activity generates revenue that exceeds its operational costs.

Short Run

A period in economics where at least one input is fixed, limiting the ability to adjust production levels rapidly.