Insurance Verification and authorizations

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Insurance Verification and authorizations

Postby amepham » Thu May 19, 2016 8:44 pm

Is anyone else having difficulty getting insurance benefits and requirements for authorizations? Primarily from Blue cross. We are constantly spending hours on the phone trying to receive benefits. However blue cross is refusing to give information over the phone. They ask to use availity, which is not much help. We are an physician owned lab within the physician's office. Therefore benefits vary from copays to deductibles depending on which benefit a sleep study falls under for each particular policy.

In addition, we are being told when verifying benefits that no authorization is needed. Later the claim comes back unpaid for no authorization.

Is anyone else having this problem? Or have a better solution???
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Re: Insurance Verification and authorizations

Postby sleepmac » Sun May 22, 2016 8:35 pm

I take it that when you talk to BC, you are keeping track of who of their staff said what, and when? You are using the correct Diagnosis and Rx Codes? We are a hospital based facility, and we don't accept Sleep Study orders unless they come accompanied with an ICD 10 code that is on the CMS list of acceptable Diagnoses, even when the insurance is not Medicare.
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Re: Insurance Verification and authorizations

Postby izzy » Fri May 05, 2017 2:39 am

do you have a cheat sheet with all of the diagnostic code along with all of the different ins? could you share? thanks
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