Free AAMA Certified Medical Assistant (CMA) Practice Question

When a medical assistant is reviewing a returned insurance claim, the claim has been denied due to incorrect linkage between the procedural code and the diagnosis code that does not support medical necessity. What is the BEST next step the medical assistant should take to correct this issue?

  • Inform the patient that they are responsible for the full amount since the insurance denial is final.

  • Generate a new claim with different codes in hopes of approval.

  • Ignore the denial and wait to see if the insurance company will pay upon a second review without resubmission.

  • Review the patient's medical record to verify the coding and resubmit the claim with the correct codes.

This question's topic:
AAMA Certified Medical Assistant (CMA) / 
Administrative
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