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Ch 17: Refunds, Follow-Up, and Appeals

MED 1850

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Across
4.The first level of appeal for physician claims with Medicare
5.A review by a group of physicians to determine the appropriate amount of payment
6.This is a type of claim that the insurance did not pay
8.This is the person at the insurance company that you can call if you have a problem with your claims
9.A process in which a provider sends a claim to an insurance company again and again until they get a response.
10.The format used for a problem-oriented visit.
11.Checking on the status of a claim
Down
1.Private companies that contract with Medicare to process appeals
2.The basis for all claims from a medical office **if it's not documented, it never happened!!**
3.An elected official in each state charged with cosumer protection and regulation of the state's insurance industry
7.You can file one of these if an insurance consistently processes your claims or appeals incorrectly

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