Has anyone been getting denials recently on their echos? My office bills only the professional component. We have been using the date that the cardiologist reads the echo, which is not matching up to the authorization for the date of service the echo is performed. We had not had problems in the past until prior authorizations were required. Our date of reading is not on the authorized date of service. How do we handle this?
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Tag Archives: Auth
Surgical prior auth
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?
Appeal for wrong place of service auth that PCP obtained
I work for an ASC and the PCP obtained an authrozation for a different Surgery center( which we did not know about ). We did the surgery submitted charges with auth number the PCP provided, and we were denied due to no prior auth obtained for our surgery center. pcp tried to change it to our facility but ins company will not change and told PCP, we will have to appeal it as the ASC. I can’t figure out how to fight this.
Thank you kindly,
Chelsa T. CPC, CPB
Blue Shiled CA auth. for HCPCS codes H2034
Has anyone seen this auth. code before. I am getting this auth. code for my DTX auths. for CA Blue Shield? but what is interesting, when search auth’s on the Blue Shield Web site, there are completely differnt codes attached to the LOC that I was orignally auth. for ? so confusing. Does anyone use the auth. tool on the CA Blue Shield Web site ? Any insight would be great.
Thanks,
Rapidrev. Coder :confused:
Denial for No Auth? can anyone help?
I recently have been getting denials for no auth being obtained from the office where services have been rendered. It’s not possible to get a back dated auth. Does anyone have a good appeal template for this? Im new to the billing field, so any feedback would be very helpful. 