Med D Case Study

FINDINGS:
1. Veterans Services: QA identified 2 errors - the effective date of combined SC% is missing.
2. Insurance: QA identified 4 errors - there's no RX on file; COB is incorrect; medical and pharmacy insurance coverage termed without verifying elegibility; and RX was incorrect should be commercial not Med D plan.
3. RUR: QA identified 1 error - it has both non SC/SA and CV on same visits.
4. Coding: QA identified claims not checked out timely and not coded timely.
5. Billing: QA identified claims were not billed timely.
5. Accts Mgmt: QA identified 2 errors - claims were validated as SC and received payments.

RECOMMENDATIONS:
1. Veterans Services: Ensure all areas of the patient's registration is complete.
2. Insurance: Ensure