Question

Raja is very relieved when her breast biopsy comes back negative; however, she is upset that the insurance company appears to think she already has a history of breast cancer. In looking at her claim form, you see that the coder mistakenly chose a code for history of breast cancer instead of family history of breast cancer. How will you handle this?

Answer 1

It is very important to input the data in a correct form for the patient's especially by the insurance companies as they are dealing with the economic and emotional problems of the patients. They should be very carefull in putting data about the patient and should not hurry in any of these things. However, in this case Raja has been accused of having a history of breast cancer which was mentioned in her insurance detail and was a mistake made by the coder.

Hence, it is very important that we should clarify our mistakes to the patient and re-enter her data accordingly to avoid any of the future problems to be faced by both the patient as well as the insurance agency.

During the time we should thoroughly examine the information provided by the patient as well as the information entered by the coderto identify the cause of the misunderstanding.

We should try to communicate it to the concerned authority and change the data as well.