A provider submitted 17 claims, each with a level 5 E&M code and a charge for a prolonged office visit, including charges for investigational medications for treatment of chronic pain and depression.
Nokomis obtained records, and ultimately denied the entire claim since the documentation did not support the claim. It’s important to review claims within their entire context and to request records where possible. In this case, our review saved our client $8,426 on claims that otherwise would have been paid. That's Claim Accountability.