Get the free Denial Code 18: Explanation & How to Address

EOB Crosswalk EOB CodeEOB Description004THIS IS AN EXACT DUPLICATE OF A PREVIOUSLY PAID CLAIM. THIS IS A POSSIBLE DUPLICATE OF A PREVIOUSLY PAID CLAIM. MULTIPLE CLAIMS CANNOT BE BILLED WITH OVERLAPPING

How to fill out denial code 18 explanation

How to fill out denial code 18 explanation

1. Gather necessary documentation, including the claim information and patient details.
2. Locate the specific denial code 18 on the Explanation of Benefits (EOB) or denial notice.
3. Understand the reason for the denial by reviewing the guidelines associated with denial code 18.
4. Prepare a concise explanation addressing the denial, ensuring all required details are included.
5. Include any supporting documents such as bills, medical records, or additional information to justify the claim.
6. Submit the explanation and supporting documents to the appropriate payer or insurance company.
7. Keep a copy of all submissions for your records.

Who needs denial code 18 explanation?

1. Healthcare providers and billing departments who have claims denied under code 18.
2. Patients seeking clarification on their denied claims.
3. Insurance companies requiring explanations from providers to resolve disputes.
4. Billing advocates or representatives assisting patients with insurance claims.

For pdfFiller’s FAQs

How do I complete denial code 18 explanation online?

Completing and signing denial code 18 explanation online is easy with pdfFiller. It enables you to edit original PDF content, highlight, blackout, erase and type text anywhere on a page, legally eSign your form, and much more. Create your free account and manage professional documents on the web.

How do I make changes in denial code 18 explanation?

pdfFiller not only allows you to edit the content of your files but fully rearrange them by changing the number and sequence of pages. Upload your denial code 18 explanation to the editor and make any required adjustments in a couple of clicks. The editor enables you to blackout, type, and erase text in PDFs, add images, sticky notes and text boxes, and much more.

Can I edit denial code 18 explanation on an iOS device?

No, you can't. With the pdfFiller app for iOS, you can edit, share, and sign denial code 18 explanation right away. At the Apple Store, you can buy and install it in a matter of seconds. The app is free, but you will need to set up an account if you want to buy a subscription or start a free trial.

What is denial code 18 explanation?

Denial code 18 refers to a claim denial issued by insurance companies indicating that the procedure or service is considered 'not medically necessary.'

Who is required to file denial code 18 explanation?

Healthcare providers who receive a denial code 18 on their claims must file a denial code 18 explanation to support the medical necessity of the services rendered.

How to fill out denial code 18 explanation?

To fill out a denial code 18 explanation, include the patient's information, a detailed description of the services rendered, the rationale for medical necessity, any supporting documentation, and reference the relevant medical guidelines or codes.

What is the purpose of denial code 18 explanation?

The purpose of the denial code 18 explanation is to provide clarity on why a service was deemed necessary, to dispute the denial, and to facilitate the reconsideration of claims by the insurer.

What information must be reported on denial code 18 explanation?

The information that must be reported includes the patient’s name, claim number, details of the service provided, medical justification, and any pertinent clinical information or documentation.