Global Period Denial

What is the Pre-operative period?

• This period occurs after the surgery where the provider monitors the patient on a timely basis to make sure that the patient is safe & comfortable

• This period occurs prior to the surgery where the provider gathers all the relevant information to make sure there is no obstacle when performing the surgery

• This is a period where actual surgery is performed

• All of the above

If you receive the status on call as the claim is denied for globally inclusive to main surgery and the DOS does not lie between the global period then what will be your next questions?

• Could you please send the claim back for reprocessing as the DOS lies outside of the global period?

• What is the TAT for reprocessing?

• May I get the Claim# & Call ref#?

• All of the above

What is the Intra-operative period?

• This period occurs after the surgery where the provider monitors the patient on a timely basis to make sure that the patient is safe & comfortable

• This period occurs prior to the surgery where the provider gathers all the relevant information to make sure there is no obstacle when performing the surgery

• This is a period where actual surgery is performed

• All of the above

What is the Post-operative period?

• This period occurs after the surgery where the provider monitors the patient on a timely basis to make sure that the patient is safe & comfortable

• This period occurs prior to the surgery where the provider gathers all the relevant information to make sure there is no obstacle when performing the surgery

• This is a period where actual surgery is performed

• All of the above

If you receive the status on call as the claim is denied for globally inclusive to main surgery and the DOS lies between the global period then what will be your next questions?

• What is the time limit to send corrected claim?

• What is the Fax# or Mailing address to send an appeal?

• How much is the time limit to send an appeal?

• All of the above

If a service with DOS - 10/19/2023 is denied for globally inclusive to main surgery and the main surgery was performed on 07/20/2023 and the global period is 90 days then Is this service denied correctly?

• Yes

• No

If a service with DOS - 10/01/2023 is denied for globally inclusive to main surgery and the main surgery was performed on 07/28/2023 and the global period is 90 days then Is this service denied correctly?

• Yes

• No

If the claim is denied for globally inclusive to main surgery and the DOS lies between the global period then what will be your action?

• Resubmit the corrected claim to the insurance

• Set the follow-up for the TAT

• Assign the claim to the coding team

• Send an appeal to the insurance

If the claim is denied for globally inclusive to main surgery and the DOS does not lie between the global period and rep agrees to send the claim back for reprocessing then what will be your action?

• Resubmit the corrected claim to the insurance

• Set the follow-up for the TAT

• Assign the claim to the coding team

• Send an appeal to the insurance

If a service with DOS - 11/16/2023 is denied for globally inclusive to main surgery and the main surgery was performed on 08/19/2023 and the global period is 90 days then Is this service denied correctly?

• Yes

• No