Top 10 Medicare Insurance Phone Call Reasons

Top 10 Reason Codes for Wisconsin, Illinois, Michigan, and Minnesota: March 2008 (Excluding Claim Status and Eligibility Issues)

Coding Errors/Modifiers 1,674
Address/Phone/Fax/Web Address 1,465
Duplicate Claim Denials 1,318
Appeals Process/Rights 1,071
Payment Explanation/Calculation 951
Medicare Secondary Payer (MSP) 949
Contractual Obligation not Met - Claim Denials 913
Medical Necessity 815
CMS-1500 Claim Form Item 791
Provider Information 755

WPS Medicare publishes FAQs specifically developed to address Top 10 Inquiry Reasons from the previous month's reporting period. We hope the answers to the questions listed below assist you in reducing claims errors associated with these topics.

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