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Coding tip of the day: Don’t take non-covered service denials at face-value

Coding tip of the day: Don’t take non-covered service denials at face-value

By Angie Stewart for Becker’s ASC Review

Insurers may wrongly deny a claim and hope providers don’t notice it’s actually a covered service, according to medical coding and billing specialist Steven Verno.

Mr. Verno shared the following tip for appealing a non-covered service on LinkedIn:

“You need proof that the insurance company is wrong. The proof can be in the form of documentation from the patient’s health benefit manual or summary plan description. Some insurance companies may have a website that you could go to, which could let you know what is covered or what is NOT (sic) covered.”

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