Providing Additional Information to Consultants

One of our members who is a consultant for a large insurance carrier reports that she had a recent call from a doctor's office about continued rejection of crowns.

"I always include a narrative if a person can't see the need for a crown on the x-rays" they reported.

The consultant had copies of several claims in front of her.

"I don't see a narrative on any of these," she said.

"Well I know I sent it in. I always write it on the x-ray envelope."

The moral of the story: if it isn't on the claim, it probably won't be seen and even if it is, the validity of it is questionable. Narratives, explainations as to why a requested service's needs and the like must be on the actual claim form if you want them to count.

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