What is Reason Code 97

What Is The Common Reason For Denial Of Reason Code 97 And How To Avoid It?

The Denial Reason Codes is known as the standard message that is used to describe or provide information to the Medical provider or any of the patients through insurance that specifies why the claim was denied.

What is Reason Code 97?

The benefits of the service Reason Code 97 include in the allowance or payment for another procedure and service that has been adjudicated already. According to the Healthcare Policy identification Segment, the service is not paid separately if the patient is an inpatient.

What is The Common Reason For Denial?

What is The Common Reason For Denial

The common reason for the denial of Reason code 97 is that the beneficiary was inpatient on the date of service billed. If you found that the beneficiary was not inpatient on the right date then it is important for you to submit a redetermination request along with all the relevant supporting documentation. If in case, the wrong date of service was billed then the supplier will call you for the reopening to correct it in an effective manner. It is important for you to check the entire documentation checklist before submitting the request to avoid any issue and mistake.

So, with the help of the above-mentioned information, you may get know that What is Reason Code 97 and what is the reasons for denial of this service. If you want to avoid future denial then browse around this site where you can get useful tips for you that can help you in the best possible way.

  • First of all, you need to verify the place of service and the date of service billed.
  • You cannot make the payment via DME MAC for the items or things received while a beneficiary used in any hospital that stays unless the equipment was delivered no more than two days prior to the discharge.
  • Suppliers may use the Medicare Portal or there can call Interactive Voice Response to verify that whether the beneficiary was inpatient or not.

So, it is the right way that helps you to know how can you avoid such denial and able to fulfill your issues. There is huge importance of reason code 97 in medical billing and this bill is included in the payment for other services in Medicare that was already adjudicated. If you want to know more about Reason Code 97 then it is beneficial for you to visit the online platform and explore several benefits of the services that help you to enhance your knowledge.

increasing technology

With the help of increasing technology, now it becomes convenient for you to get knowledge about each and everything without having any issue and problem. You can explore anything with great comfort and able to know everything regarding Reason Code 97 that helps to enhance your knowledge span. This service has lots of benefits for you and it is important for you to get complete knowledge about the denial codes and their reasons so that you can save your time and money as well in a most effective manner.