Extra details requested - [rejection management] in medical billing

#denialmanagement.
#medicalbilling.
#dminmb.

Understanding denial reason:.

Insurance requesting any info from provider or client after submitting claim is called additional information asked for.

It is suggested by rejection code 226 and227

226 is information requested from provider.
227 is information requested from patient.

Extra information like medical records, Client’s COB or W9 kind etc are requested to process the claim.

initially thing first, we require to check remark code.
Remark code explains what precise information is asked for.

If details asked for from client, need to forward to collection team and Details asked for from supplier require to send documents together with reconsideration kind.
If there is no remark code on EOB. Required to call insurance to verify what info asked for by payor.

remark code website: https://www.wpc-edi.com/reference/codelists/healthcare/remittance-advice-remark-codes/

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http://medicalbillingcodingonline.org/extra-details-requested-rejection-management-in-medical-billing/