Interesting scenario-had to give a denial letter,patient dc/d therapy,lived with his
wife,daughter had to go out of town day after therapy dc/d so wanted him to stay 4
days until she returned.We said sure but he'll be private pay.She asked us to leave
letter with patient and his spouse who was competent.Say letter dated today,off med A
tomorrow,on page 2 states who was informed of the denial with today's date.Patient
goes home,daughter signs letter 2 weeks later and wants a medicare determination.Of
course there was no certified letter as back up when it went to patient except the
letter itself.FI inially refused to pay claim because they couldn't understand why it
took 2 weeks to get it signed.The business person told FI there is no reg as to when
it is signed,finally found in our favor but what a hassle.So watch out for
technicalities.
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