tci Part B Insider - 2014 Issue 10

Denial Management: Respond Appropriately to These 5 Common EOB Denials

Know the denial codes and then set a course for appeal when applicable. All explanations of benefits (EOBs) for denials are not alike, and if you can’t distinguish between them, your appeals could be worthless. Review these common EOB denials and respond adequately to ensure that you don’t let any reimbursement opportunities fall through the cracks. N643 Denial: The services billed are considered Not Covered or Non-Covered (NC) in the applicable state fee schedule  Your response: Don’t appeal. Bill the patient if you have an ABN. You don’t have to worry about appealing denials with...

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