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Member Service Request Form Instructions At UnitedHealthcare, we continuously strive to bring you a higher level of service. Although you are not required to submit this form, completing it will help

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How to fill out explanation of benefits code

01

Check the explanation of benefits form to find the code section

02

Locate the procedure or service code for which you are being billed

03

Match the code to the corresponding explanation provided on the form

04

Ensure all the information is accurately entered and documented

Who needs explanation of benefits code?

01

Individuals who have received medical services

02

Insurance companies

03

Healthcare providers

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What is explanation of benefits code?

Explanation of benefits code is a unique code used to indicate the reason for a specific medical service being denied or adjusted.

Who is required to file explanation of benefits code?

Healthcare providers and insurance companies are required to file explanation of benefits codes for billing and claims purposes.

How to fill out explanation of benefits code?

Explanation of benefits code should be filled out by inputting the appropriate code that corresponds to the reason for denial or adjustment of a medical service.

What is the purpose of explanation of benefits code?

The purpose of explanation of benefits code is to provide transparency and clarity regarding the billing and payment process for medical services between healthcare providers and insurance companies.

What information must be reported on explanation of benefits code?

Explanation of benefits code must include details such as the reason for denial or adjustment, the date of service, the code for the specific medical service, and any other relevant information.

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