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Managed Care Nursing

Category - Patient Issues

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What are the chronologically correct steps for an insurance external appeals process?

Claim denied in final by insurance, file for an external review within 30 days of insurance denial, await final decision of external reviewer
Claim denied in final by insurance, file for an external review within three months of insurance denial, await final decision of external reviewer
Claim denied in final by insurance, file for an external review within 60 days of insurance denial, await final decision of external reviewer
Claim denied in final by insurance, file for an external review within six months of insurance denial, await final decision of external reviewer
None of the above

Explanation

Answer: C- The chronologically correct steps to follow for insurance external appeals are claim denied in final by insurance, file for an external review within 60 days of insurance denial, and await the final decision of the external reviewer.

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Managed Care Nursing

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Managed Care Nursing

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