Medical Billing Forum

Billing => Billing => Topic started by: dawneddings on September 29, 2008, 06:42:58 PM

Title: Principal Procedure does not fall within Statement Covers Period
Post by: dawneddings on September 29, 2008, 06:42:58 PM
I received a denial from the insurance company stating "principal procedure does not fall within Statement Covers Period". The patient came into the ER at 9pm one evening and had a procedure, he was then admitted to the hospital the next day at 3am (6hours later). So the Statement covers period is from the date of the admission but the principal procedure date is the day before because the patient was seen in the ER.

Can anyone tell me how to bill this differently? What am I doing wrong?

Thank you in advance! ;D
Title: Re: Principal Procedure does not fall within Statement Covers Period
Post by: Michele on September 29, 2008, 07:57:04 PM
I haven't come across this problem before.  I hope someone else can help us out here.

If no one else responds, I would recommend calling the insurance carrier and asking them how to handle it.


Michele