ACE
New
We had a service on a claim denied because we did not include the diagnosis that supported the service. It was an oversight and we asked the biller to re-submit the bill to include the appropriate icd9 code. The documentation supports the icd9 and we have documented the error on hard copy. She states because it is a M-Care Advantage insurance it may trigger future audits. Also, she also states it would have to be an appeal, not a re-submit (I don't understand this part.) Does anyone have any feedback on this?