I am needing help with a surgery getting denied by their insurance. Patient was admitted thru the er. The hospital staff prior authorized the inpatient stay but did not get one for any surgeries, with the insurance company with a diagnosis of back pain. The patient went on to have spine surgery during this stay. The insurance has paid the hospital including the operative charges, even our assistant surgery charges ( assistant surgeon does not need a p.a.) but they have denied our primary surgeon charges. Any suggestions to get this corrected? By the time it gets to our office to bill it out the patient is usually already home & recovering from surgery?
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