How Does Incorrect Patient Information Impact A Claim?

1638 Words7 Pages
(1) How does incorrect patient information impact a claim? Responsible coder collects post and manages account payments, submitting claims and keeping in touch with insurance companies. If patient information is coded incorrectly, or incomplete it could leave an impact that can be brought to a claim. Inaccuracy in patient information can lead to denials, none payment and investigation. It is important to get all the details right by verifying insurance coverage properly. Make sure that the patient’s name is spelled correctly, date of birth and sex of the patient are correct; and most important be sure that the policy number is valid.0verall before claims are sent, documentation should be in order and the claim should be checked for completeness and accuracy. (2) What is correct coding? What is meant by a clean claim? Correct coding is when a claim is coded accurately for example the patient name is spelled correctly date of birth and sex are correct. The insurance will definitely know exactly what illness or injury the patient has and the method of treatment that was performed by the physician. A “clean” claim is one that does not require the payer to investigate or develop on a prepayment basis. This claim is filed in the timely filing period and passes all edits; and does not require external development. A clean claim must have all basic information to adjudicate the claim, and all required supporting documentation is attached to the correct insurance. The required
Open Document