Allison is overwhelmed in her new job in the insurance claim processing department. Her supervisor is Looking for a pending claim in Allison’s desk and finds a drawer marked “ Returns,” which contains nearly A hundred returned claims sent back by the carriers for various reasons. List 3 reasons that claims could Be returned by the insurance companies. 1. Incorrect or missing name or NPI of referring physician on Claim for consultation or other services requiring this information. Attachments (for example, Prescriptions, operative report, manufacturer’s invoice) or Medicaid verification (for example, labels Identification numbers) are missing. 2 the diagnostic code is missing, incomplete, invalid, or not in Standard nomenclature (for example. missing fourth or fifth digit); it includes a written description or Does not correspond to the treatment (procedure code) rendered by the physician. ommitted, incorrect, Overlapping, or duplicate dates of service. 3. Information missing on patient portion of the claim form.
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