Are the Welcome plan first four outpatient office visits counted down according to date-of-service?
No, The visits are counted down by which ones hit the claims system first. In other words, if a members has two visits a few days apart, there is a chance the last visit might clear the claims system before the first visit. If the above scenario happens, then the member may appeal the claim to have the order reversed (this would be if the member has an expensive claim that processed as the fifth and not the fourth claim). (Question and answer provided by Group Health).
Related Questions
- How can I obtain a reference number for outpatient visits for a Tufts Health Plan member who is new to my practice?
- Is there a direct crosswalk from consults to office/outpatient visits or consults to hospital or facility visits?
- Are the Welcome plan first four outpatient office visits counted down according to date-of-service?
