Unformatted text preview: can be a²ached to the claim electronically or it may happen to be that it is not an op±on and it will have to be added manually to the primary EOB to a paper claim and re-billed to the secondary. The third reason is having a max frequency or beneFt is reached for the person ge³ng the service such as rou±ne services or an immuniza±on. In this case the Frst ac±on to take should be to call the payer (which is the insurance company) and ensure that the claim was processed correctly. If the medical professional feels that the service was rendered due to medical necessity regardless of the frequency, the provider should appeal the denial with suppor±ng medical documentary....
View Full Document
- Fall '15
- insurance companies, insurance company, Xaira Estrada, primary EOB