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ED Coding and Reimbursement Alert

Reader Questions:

Don’t Count on Appeals for Unprocessable Claims

Published on Mon Jan 18, 2021

Question: We received an “unprocessable” claim from our Medicare Administrative Contractor (MAC). Can we appeal this? Ohio Subscriber Answer: No, you can’t appeal an unprocessable claim because, technically, it was never filed. Another term for” unprocessable” is “rejected.” Rejected claims never enter the adjudication process as denials do. If a claim is deemed unprocessable, the reopening unit won’t be able [...]
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