Re: CDT-5

From: Dr Steve (nospam_at_home.net)
Date: 12/08/04 

Date: Wed, 08 Dec 2004 21:49:23 GMT

Electronic submission is much better. The claim is never looked at by human
eyes, unless the claim does not meet eligibility requirements, or includes a
CDT which requires documentation. Errors are eliminated. Of course, JLT
(Jardine) has to get more creative to deny claims, so they will randomly
kick back an electronic claim saying the client id does not match their
record. So, those have to printed to paper and mailed. This stalls payment
for a week or two, so the computer finds the client ID # just fine then. In
the old days of all paper claims, the carriers would train the staff to
actually throw out a few claims out of every pile. That was why so many
claims would get lost, but never come back in the mail. 

-- 
~+--~+--~+--~+--~+--
Stephen Mancuso, D.D.S.
Troy, Michigan, USA
....................................................
This posting is intended for informational or conversational purposes only.
Always seek the opinion of a licensed dental professional before acting on
the advice or opinion expressed here.  Only a dentist who has examined you
in person can diagnose your problems and make decisions which will affect
your health.
......................
"Tony Bad" <spamspamspam@bakedbeans.spam> wrote in message 
news:DRItd.395$iH3.157@fe11.lga...
>
> <purple543210@yahoo.ca> wrote in message
> news:1102533738.078620.260940@f14g2000cwb.googlegroups.com...
>> It is bull that the insurance carriers force anyone to use any codes.
>> They need to pay the claims based on what is done.
>> for example you did a crown on #19 they need to pay for it regardless
>> of what their software says.
>
> I found out recently that a lot of the data entry on these claims is done
> overseas! The claims are "read" by someone who may not even read english, 
> and
> all they understand is the code. I have forgotten the "d" that is now 
> supposed
> to proceed every code and got the claim back because it was "not a current
> code". Also, don't bother writing any notes on the claim, because the 
> claims are
> often tossed out after the data entry people are done. I found this out 
> when I
> asked someone at MET, well, didn't you read my note?
>
> Grumble, grumble...
>
> T
>
>