If a Claim Is Denied Due to Lack of Medical

question 83

True/False

If a claim is denied due to lack of medical necessity, the provider must refund any payment made by the carrier and can bill the patient for the balance.

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Definitions:

Basic Needs

Fundamental requirements that serve as the foundation for survival, including water, food, shelter, and safety.

Self-determination

A psychological concept suggesting that individuals have innate needs for autonomy, competence, and relatedness, which when fulfilled, can lead to enhanced motivation and wellbeing.

Core Virtues

Fundamental qualities or values considered essential to leading a moral and fulfilled life, such as honesty, courage, and compassion.

Honesty

The quality of being truthful, fair, and free from deceit or fraud in actions, speech, and intentions.