tci Part B Insider - 2004 Issue 30

Studies & Surveys: Don't Count On Carrier Call Center For Answers, GAO Charges

But GAO answers its own questions wrong as wellCarrier customer service representatives (CSRs) provided wrong or incomplete information in response to a stunning 96 percent of test calls, the General Accountability Office reveals in a recent report. On one question, about two procedures performed on the same day in separate sessions, 36 CSRs provided "partially correct or incomplete" responses, and 38 provided incorrect responses. Only one out of 75 CSRs answered correctly, the GAO said. The GAO believed that providers should bill using the -22 modifier (Unusual services) in this situation, but the CSRs recommended -51 (Multiple surgeries, same...

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