BC Advantage - 2017 Issue 9

Responding to The Letter

When the dreaded letter arrives from a special investigative unit of one of the big insurance payers or from a ZPIC, MAC, RAC, MIC, etc., your organization should waste little time in working on lining up professional support. Support to help craft your response, as well as begin the process of gathering all necessary documents to support the services provided and billed. However, the one question I get over and over is, “What if we cannot legitimately respond by the date requested, what can be done?”It is frustrating enough to receive a letter demanding medical records...

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