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AO3 - Service claimed by another practitioner

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Background:

The service code submitted is only allowed once per patient per day and it has been billed by another physician. Physicians are suggested to communicate with each other whenever they provide similar services to the same patient on the same date.

Solution:

  • Delete the service code and resubmit (if there are other service codes attached to the claim)
  • Resubmit with an alternative code.
  • If the other physician has billed by mistake, he/she needs to submit an RA inquiry to reverse the payment for the service claimed before you can resubmit the code.

As an example: If the error code AO3 is applied to A933 (On-call admission assessment), it means the admission assessment has been billed by another physician. The physician needs to change the service code to an alternative code (such as inpatient visits) and resubmit the claim. To appeal this rejection, the patient notes may be required by the Ministry of Health.

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