Garbage benefit rule

Our claim rejected with benefit exhausted as 2 * 2d scan has been used in the current pregnancy. This is one the was done in Nov last year, one in Jan and then rejected the one for March. You will notice or should notice the 2 scan that were done this year were done by a fetal specialist. Your annexure does not make mention that the 2d scan are per pregnancy. The other questions is why can it not be paid from the day to day, again nothing in the annexures. Then you want a motivation as to why additional scans are being done in order for the payments to be reviewed. With discussed on reference number 160323qkmmrl it was mention as to why we were referred to a fetal special and the history of the current dependant 02 should be enough motivation as to why a fetal specialist has been consulted for this pregnancy. Kindly investigate you clauses in your annexures and reprocess the claim line for Tariff code 3617 for the service date 13/03/2023 for payment.