What should the medical biller do?

Question

Dr. Jones received a HIPAA 835 Remittance Advice (RA) stating that the reimbursement for the claim was adjusted because the information furnished does not substantiate the need for the billed level of service. Which one of the following does the medical biller do next?

Answer 1

You need to request an appeal..... send the company all original bills and reports with a written statement asking for a reconsideration.. Thats what we do here anyways.. I dont know if it differs by state..