Medical Billing Coding - Denials for Pre-authorizations, cpt, codes
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Thread Topic: Denials for Pre-authorizations
Topic Originator: Scott
Post Date June 2, 2013 @ 12:55 PM
Denials for Pre-authorizations

June 2, 2013 @ 12:55 PM Reply  |  Email Friend   |  |Print  |  Top

Hi..I am worried about the claims that are being denied for missing pre-authorization/pre-certification as when they are denied by payer they automatically are being written off per Dr.'s advice. I just wanna know if we can bill such claims to patient or is there any way that we get the payments??? please suggest

Khawaja Sohail
June 2, 2013 @ 8:42 PM Reply  |  Email Friend   |  |Print  |  Top

If you are talking about facility claims, call the payer and discuss the authorization for that specified facility where services rendered. If they will have auth, claims will be re-processed. Also confirm the patient's PCP. If it is different than physician who provided services, ultimately patient will be responsible if s/he don't have out of network benefits.

Khawaja Sohail

Khawaja Sohail
June 4, 2013 @ 7:05 PM Reply  |  Email Friend   |  |Print  |  Top

CPT Code inactivated since January 2011. Mistakenly typed 2013 in previous post.

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