AAMA CMA Practice Question

The most appropriate method to address a rejection stating that the service appears excessive for the patient's condition involves appealing the rejection with a detailed explanation or letter of medical necessity from the physician. This should include relevant patient history, explanation of why the service is necessary, and any supporting documentation that justifies the service based on the current medical condition of the patient. Resubmitting the claim without additional information or transferring the balance to the patient would not address the payer's concern regarding the medical necessity of the services rendered, and sending a generic appeal without detailed justification would be less likely to reverse the rejection.