A medical assistant is conducting end-of-month billing procedures and identifies several claims that have exceeded the typical 45-day period for insurance reimbursement without payment or denial notification. What is the MOST appropriate action for the medical assistant to take?
Send a standard letter to patients informing them of the unpaid claims.
Wait another week to see if the insurance companies will respond before taking any action.
Notify the provider or supervisor about the delayed claims and wait for further instructions.
Contact the insurance companies to inquire about the status of the claims.
The correct procedure in this situation is for the medical assistant to follow up with the insurance companies regarding the status of the claims. Timely follow-up is crucial to ensure that unpaid claims are addressed and resolved, which could involve re-submission, providing additional information, or correcting any errors that may have led to the delay in payments. Notifying the provider or supervisor would generally come either after determining the cause of delay or if the medical assistant requires further advice or authority to resolve the claim issues. Waiting another week is not a proactive approach, and contacting patients directly is inappropriate until it's confirmed that there is patient responsibility for the claim (such as due to a rejection or patient deductible).
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