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A patient who received90 tabletsone month ago contacts the pharmacy to request a refill. The insurance rejects the claim, saying that the refill is56 days too soon.The claim rejection is likely the result of submitting an incorrect:
Suggested Answer: D
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40 comments · newest first
LO
Louis
11 months ago
NDC number seems less likely, but who knows?
LY
Lynna
11 months ago
I disagree, it could also be the quantity submitted.
KA
Kaycee
12 months ago
Wait, how can it be 56 days too soon? That's wild!
CA
Casie
12 months ago
Definitely A, they probably calculated it wrong.
WI
Willie
12 months ago
Sounds like a days supply issue to me.
VO
Von
1 year ago
I’m a bit confused about the indication part. I don’t think it would cause a refill issue, but I could be wrong.
GL
Gladys
1 year ago
This question seems similar to one we practiced where the days supply was incorrectly calculated. I think that’s the most likely reason for the rejection here.
DO
Dorothea
1 year ago
I’m not entirely sure, but I think the NDC number is more about identifying the drug itself rather than affecting the refill timing.
SA
Sabra
1 year ago
I remember discussing how days supply can affect refill requests. If they were supposed to get 30 days but got 90, that could definitely be an issue.
CA
Caitlin
1 year ago
Okay, let me try to break this down step-by-step. I think the key is understanding the radix parameter.
LO
Louisa
1 year ago
Automatic sourcetyping sounds like it could help, but I'm not sure if that's the best practice. I'll have to weigh the options.
BE
Berry
1 year ago
I'm pretty sure the answer is B. Key goal indicator seems like the right performance measure to assess a specific focus area.
VA
Val
1 year ago
The answer is clearly C) Quantity. I mean, who doesn't know that 90 divided by 30 days is 3? Insurance companies must have some serious math issues.
LA
Lanie
1 year ago
User 3: The quantity must have been entered wrong for the claim to be rejected.
TE
Terrilyn
1 year ago
User 2: Yeah, they probably just want to make sure everything is accurate.
CA
Candra
1 year ago
User 1: The insurance company is so strict with refills.
LE
Levi
1 year ago
Indication? What is this, a mystery novel? The insurance just wants the facts, ma'am.
TA
Tanesha
1 year ago
C: Quantity
SA
Salena
1 year ago
B: NDC number
AN
Anika
1 year ago
A: Days supply
AR
Arlette
1 year ago
Quantity? Come on, who can't count to 90? Well, maybe the insurance company needs to invest in some better arithmetic skills.
OL
Ollie
1 year ago
C) Quantity
SC
Scarlet
1 year ago
B) NDC number
IR
Ira
1 year ago
A) Days supply
LY
Lynelle
1 year ago
NDC number, huh? I bet the pharmacist just grabbed the wrong bottle and scanned the wrong code. Rookie mistake!
DE
Deeanna
1 year ago
D: Indication
BE
Beckie
1 year ago
C: Quantity
KA
Katlyn
1 year ago
B: NDC number
AP
Apolonia
1 year ago
A: Days supply
VE
Verona
1 year ago
D: Indication
LA
Lasandra
1 year ago
C: Quantity
AM
Ammie
1 year ago
B: NDC number
TI
Tiffiny
1 year ago
A: Days supply
LA
Lashon
2 years ago
Days supply, definitely. The insurance company is all about that precise data. Gotta get those numbers right!
JA
Janey
1 year ago
B) NDC number
EL
Elke
1 year ago
Days supply is crucial for insurance claims.
ME
Merlyn
1 year ago
A) Days supply
AL
Alethea
2 years ago
I'm not sure, but I think it could also be C) Quantity. Maybe the pharmacy dispensed too many tablets at once.
GA
Gail
2 years ago
I agree with Staci. The patient received 90 tablets one month ago, so the days supply must have been calculated incorrectly.
ST
Staci
2 years ago
I think the answer is A) Days supply.