MA Script – No Contract Underpayment
May 24, 2020 5:13 pmASK YOURSELF: Make sure we are contracted with the plan. What date was the claim initially billed? When did the... View more
ASK YOURSELF: Make sure we are contracted with the plan. What date was the claim initially billed? When did the... View more
ASK YOURSELF: Is this claim or appeal “truly” filed late or has the plan mishandled the initial timely submission of... View more
ASK YOURSELF: What date was the claim initially billed? Was there any written communication (request for information, denial, underpayment) from... View more
ASK YOURSELF: Was the coverage terminated? Did we verify eligibility? IF SO, WHAT DATE? Did the plan make negligent misrepresentation... View more
ASK YOURSELF: How many days after payment, did the MA plan request the refund? Why did the plan request the... View more
ASK YOURSELF: Who denied the claim? What is the professional’s license number with the State Medical Board? Were they a... View more
ASK YOURSELF: What was the patient’s presenting symptoms or chief complaint in the emergency room? Did the plan pay for... View more
AFFIDAVIT OF COMPLIANCE Post-Stabilization Care Services Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients: ... View more
AFFIDAVIT OF COMPLIANCE Retroactive Denials for Authorized Care Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients:... View more
AFFIDAVIT OF COMPLIANCE Notice Requirements for Adverse Determinations Incorporated by Reference in 28 US Code § 1746 Patient/Multiple Patients:... View more