9/14/2023 0 Comments Do not duplicate meaning![]() ![]() Was the first claim submitted denied? If denied, was the denial handled correctly? Some insurances will allow you to simply correct a diagnosis code, modifier, or other problem and simply resubmit the claim.Was the payment sent to the patient for failure to check the 'accept assignment' box on the HCFA form?.Has the check been deposited and somehow missed in the posting process?.Was payment made on the first claim and if yes, was it sent to the correct address?.If you find you have actually submitted the claim twice then you may need to verify a few things: If you had already done that and it still denied simply submit a letter of appeal with a copy of each report for that specific service for proof it was performed more than once and therefore is not a duplicate service.Ģ. If it was performed more than once during the same day and by the same provider, you may need to append modifier 76 and rebill. Modifier 50 or RT and LT modifiers appended would indicate the same procedure performed bilaterally and may clear up the confusion. If the service was performed more than once on the same day it may be eligible for a modifier. How to respond to a claim denied as a duplciate:ġ. Another physician performed the same service on the same date and submitted a claim with the same CPT code you did, which was processed prior to your claim.The service was performed once but billed twice.The service was performed more than once on the same day validating the denial.Three reasons a claim may be denied as duplicate: If the service has been performed and billed only once, then contacting the insurance company and reviewing the claim with a claims specialist may be the best option.ĭuplicate service denial is indicated when the same service was performed on the same patient on the same date and by the same provider. Review the record to verify that the service rendered was actually performed and billed just once. When the insurance denies a service as duplicate but your records indicate this is not true, how should you act? ![]() News - industry news & Find-A-Code updatesĬlose Was Your Claim Denied as a Duplicate Service?Įvery practice, on occasion (if not more often) receives a denied claim notification that states the service has been denied as a duplicate.Marketplace - recommended products & services.Library - buy digital books from Find-A-Code.Bookstore - buy physical books & cheat sheets.Subjects - Audits, E&M, HIPAA, Practice Mgt, etc.Specialties - Cardiology, ENT, Family Practice, etc.Payers - Medicare, Medicaid, BC/BS, Aetna, etc.Facilities & Organizations - ACOs, Hospitals, etc. ![]()
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