#NOT

NOTE: Please CORRECTION HERE:
We can not resubmit (with resubmission code 7 ) a corrected claim to Traditional Medicare (Just we refile after coding corrections). But for HMOs or managed care we can do. Thank you.
#Not medically necessity
#Denial management
#Medical billing
#AR in Healthcare
#Medical coding
#AR
#US HEALTHCARE DOMAIN
Summary: If services are not covered as per LCD & NCD guidelines, then claim will be denied as services are not medically necessity. Denoted by denial code 50. This denial commonly seen in Medicare and Medicare advantage plans. Provider need to check whether services are covered as per LCD, NCD guidelines under the patient. We need to forward claim to coding team in further. After coding correction done have to rebill the corrected claim with resubmission code 7. If no coding correction required, need to check if ABN signed and if ABN signed then BILL PATIENT. If ABN NOT SIGNED, provider need to WRITE OFF THE CLAIM BALANCE thats mean that CLAIM WILL BE ADJUSTED.
ABN: Advance Beneficiary Notice (ABN) for non covered services as per Medicare guidelines, also known as a waiver of liability.
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