Remittance Advice: The claim for S. Smith, a 10-year-old that had a tonsillectomy on 5.8.15, was...
Remittance Advice:
The claim for S. Smith, a 10-year-old that had a tonsillectomy on 5.8.15, was billed with the following information on May 12, 2015.
S. Smith
123 New Road
Bridgeville, OH 44556
DOB 6.12.50
CPT code 42825
Claim adjustment reason code (CARC) 6 returned on the remittance advice to indicate the procedure was not paid.
1. Determine the issue that the CARC identifies and what steps must be taken to correct it. Be specific in your answer.
2. What does the claim adjustment reason code 6 mean?
3. What is the specific error in the patient information?
4. What should be done to correct the error?
Homework Answers
1. The reported services are not consistent with the dx or do not meet the general accepted professional standard of care.
2. The procedure or revenue code is inconsistent with patients age.
3. The age given and date of birth does not match
4. RARC update schedule can be done.
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The claim for S. Smith, a 10-year-old that had a tonsillectomy
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words:
Q: Compare the assumptions of physician-centered and
collaborative communication. How is the caregiver’s role different
in each model? How is the patient’s role different?
Answer: Physical-centered communication involves the specialists
taking control of the conversation. They decide on the topics of
discussion and when to end the process. The patient responds to the
issues raised by the caregiver and acts accordingly. On the other
hand, Collaborative communication involves a...
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