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RCM Q&A 1 Claim in Process : Top RCM Technical Questions and Answers with Sample notes Format for: Claim in process

RCM Q&A 1: Top RCM Technical Questions and Answers with Sample notes Format for Claim in the process:

Interviewer Question: How do you work on  - In Process Claim

Answer : 

Step1: Check with the Clearing House to see if your claim has been accepted.

Step 2: *Considering both Clearing House and Insurance Accept Check Claim

Step3: *Considering - Insurance has not responded. After 15 days from the date of the Clearing House and Insurance acceptance.

Step4: Claim Status can be located on the insurance website, however in our scenario consider there is no information about it.

Step5: Call the Insurance Company

Step6: Once you reached the Insurance Representative, after providing basic information about the claim. You need to ask the following questions May I know the Claim received date 

Step7: May I know how many days it may take to process the claim

Step8: If the received Date is more than 30 days then need to ask the below questions

Step9: May I know the reason for the dealy

Step10: May I know the patient's effective and termination date

Step11: When shall I call back to you

Step12: May I know the claim#

Step13: May I know the call ref#

Sample Notes Format : 

Checked no status found on Clearinghouse and Insurance web portal hence called insurance and spoke with Sam for Dos mm/dd/yyyy Stated claim was received on mm/dd/yyyy and it is in process. The rep informed me it would take 10 business days to complete processing. Clm#12345. Ref# 54321

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