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If a Carrier Downcodes a Claim and the Provider Maintains

Question 56

Multiple Choice

If a carrier downcodes a claim and the provider maintains that the reported services were medically necessary, the medical office specialist should:


A) send a bill to the patient for the remaining balance.
B) write off the remaining balance.
C) file an appeal with the insurance carrier.
D) send a complaint to the state insurance commissioner.

Correct Answer:

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