Third Party Reimbursement

Insurance company has requested a copy of a patients inpatient record to reconcile the documentation in the record for a claim for laboratory service of $200.00 and a radiology service charge of $325.00. Upon review of the record the insurance company had determined that the laboratory report does not contain documentation for a laboratory test billed at $50.00. Should the insurance company deny the whole claim or just the $50.00 bill?

re: Third Party Reimbursement

I would think that the payer would deny the entire claim, then pay after the corrections were made. It may depend on the payer and their policies and guidelines.