Medical Billing Forum
Billing => Facility Billing => : Philip August 07, 2009, 01:02:42 AM
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we sent a claim to Insuarance company for homehealth . it is rejected. we sent a corrected claim. When I called 4-5 times, they said it is processing.Today I got a mail saying the claim is denied.Icalled and asked, they said there is no problem and they will reprocess it.They said we will get the money within 15-60 days. Anybody please help? What should I do next? Do I have to appeal? How will I appeal ? What should I do next? Any body please advise;
Thanks
Suma
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How can we or anyone help without knowing details? why was the claim denied?
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we sent a claim to Insuarance company for homehealth . it is rejected. we sent a corrected claim. When I called 4-5 times, they said it is processing.Today I got a mail saying the claim is denied.Icalled and asked, they said there is no problem and they will reprocess it.They said we will get the money within 15-60 days. Anybody please help? What should I do next? Do I have to appeal? How will I appeal ? What should I do next? Any body please advise;
Thanks
Suma
You can't appeal something that hasn't been "denied" Your posts says it should pay within 15-60 days. Looks like you will be playing the waiting game. You can call after 15 days to check on the status.
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I got a mail saying the claim denied because the CBSA code is not correct..Then I called the Insurance company. They said everything is correct and they will reprocess it. ( They put me on hold and they said they are checking and forwarding the claim againto process)That's what happened.Then I asked how long it will take to proces. she said 15-60 days.They gave the reference number too.
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Usually you don't get "a mail" that a claim was denied.. you get an EOB with the denial code listed. A CBSA error.. would cause the carrier to reject, so I suspect it was a matter of the claim rejecting in error NOT a denial, there is no denial for CBSA because that's on the carriers end.
You have two choices. Play the wait game and keep pestering them or re-send it.
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yes , it was an EOB. after I agot that, I called and they said everything is correct. So as you said , I will wait few days and then resend it. Is that okay?