denied claim

  1. E

    Primary Diagnosis Z30.011

    Scenario: Patient presents to PCP's office for oral contraception initiation (Z30.011) and that is the only thing discussed. The patient's insurance is Blue Cross Blue Shield MI. In the past, claims have been denied stating the dx used is not a covered diagnosis with a contractual obligation...
  2. lamiller

    Wiki Denials CPT 45385 with 45380

    I am having a lot of denials from Blue Cross Medicare Advantage in Tennessee when billing 45385 and 45380 together. I have tried several different modifiers on 45380 including, 59, XS. XU and 59/51. The denial comes back stating claim specific negotiated discount. Anybody have any ideas?
  3. L

    Wiki AARP Medicare Supplamental Plan F and pre-existing condition denial

    I recently received a denied claim from AARP (Medicare supplamental plan F), DOS 03/15/18, for pre-existing condition. According to our records the patient had this AARP plan since 2005, followed by our office since 2013, and claims were paid by AARP (same Plan F). I called and spoke to a...
  4. A

    Wiki What is insurance claim denials and re-submission

    What are the best practices to reduce health insurance claim denials and resubmit / handle returned claims? I need to know about the process to help maximize claim approvals. Thanks.
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