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  1. J

    Wiki No authorization for Physician Services while Patient was Inpatient

    We are on trauma call at our local hospital and we bill our surgery charges under the hospital's authorization number and just mark the claims emergent. We haven't had any issues with getting our claims paid by other insurance companies. We terminated our contracts with UHC so we rarely have to...
  2. J

    Wiki 21196 & 21141

    I don't know about Medicaid but you can bill these codes as in or outpatient with commercial insurances. Some insurance companies - mainly Cigna - won't even authorize these codes as inpatient anymore so we have to book the cases as a 23 hour stay.
  3. J

    Wiki CPC-A need jobs.

    My office is looking for someone to do insurance verification for both medical and dental as well as charge entry once trained. Oral Surgery office in St. Petersburg. This position is not remote but if you're interested let me know. After 90 days - medical & dental insurance provided, uniforms...
  4. J

    Wiki Medical vs. Dental Codes

    We bill the dental codes to medical for wisdom teeth extractions and anesthesia and haven't had any issues with duplicate denials. The dental codes are on our medical contract with BCBS and most other medical insurances so reimbursement isn't an issue either.
  5. J

    Wiki Medicare Private Contract

    Does anyone know if patients with Medicare Advantage plans also need to sign the private contract? We opted out and we have Medicare Part B patients sign the form, but we weren't sure if the Medicare Advantage members should also sign. Thank you in advance!
  6. J

    Wiki Copay on Unauthorized visits

    Whenever we have gotten a denial for no prior authorization the EOB shows we have to adjust off the service completely with a $0 patient responsibility. So no the provider would not keep the patient's copayment. What does the EOB show?
  7. J

    Wiki Optum denials

    We constantly get medical records requests from Optum and they take 4-5 months to review and make a determination. It's making our UHC AR a complete disaster. They also just recently they sent us a list of over 100 claims for post-service review. Some of those claims were as far back as 2018...
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