Thursday, July 15, 2010

Ins denial and action for PR -35 Lifetime benefit maximum has been reached.

Denial Code :

PR -35 Lifetime benefit maximum has been reached.

Reason :
Benefits exhausted

Action: 

When you get a denial with the above reason then check the system to see if the patient has any secondary insurance, if there is no sufficient information provided in the system then go back to the original file in which the patient’s insurance information was received and if there is a secondary insurance, the claim can be submitted to the secondary insurance, if it does then refile claims to that Insurance.


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