How do I fix this? Appeal or phone call?

micki127

Guru
Messages
145
Location
Derry
Best answers
0
Hi,

I had a corrected medicare claim that was primary and a consult was billed out. The correction was made for a level 3 E/M. Medicare sent the corrected claim to the secondary insurance (Anthem) and now the secondary insurance wants to take back the difference between a consult and the level 3 E/M visit. What is the best method to handle this? Do I inform the secondary insurance that the visit was a consult and no take back is warranted. Also, would a simple phone call fix this or would I need to appeal it?

Thank you in advance.
Micki
 

cgaston

Expert
Messages
494
Location
Clarence, NY
Best answers
0
You cannot accept more than the Medicare allowed amount for this service so you will have to refund Anthem the difference.
 
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