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Health Net - Appeals processing same underpayment amount
by ferahs » Wed Jul 12, 2023 5:38 pm
in Others
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- 15
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by ferahs
Wed Jul 12, 2023 5:38 pm
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Maintenance of Benefits
by thaddock » Wed Dec 30, 2020 7:16 pm
in Others
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- 25
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by thaddock
Wed Dec 30, 2020 7:16 pm
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denials and pt responsibility
by Guest » Mon Aug 10, 2020 7:26 am
in Refund/Recoupment
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- 59
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by Guest
Mon Aug 10, 2020 7:26 am
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UBH MNRP - SUBSTANCE ABUSE REV CODES
by Guest » Mon Jan 23, 2017 2:29 pm
in United Healthcare
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- 187
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by Guest
Mon Jan 23, 2017 2:29 pm
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LA CARE DENIALS
by avmedical » Mon Jul 13, 2015 3:37 pm
in HMO/PPO
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- 198
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by avmedical
Mon Jul 13, 2015 3:37 pm
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GEHA - DENIED NOT MEDICALY NEC.
by fcmg » Thu Mar 19, 2015 10:40 am
in Medical Necessity
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- 269
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by fcmg
Thu Mar 19, 2015 10:40 am
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aetna denying anesthesia
by MBPM » Wed Jan 21, 2015 2:22 pm
in Aetna
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- 209
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by MBPM
Wed Jan 21, 2015 2:22 pm
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Nursing Home Appeal Due to Unsafe Discharge
by Guest » Sun Mar 30, 2014 9:38 pm
in Medical Necessity
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- 43
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by Guest
Sun Mar 30, 2014 9:38 pm
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UCR and ACA State/Federal External Review
by sonnybloom » Fri Dec 13, 2013 5:08 pm
in Incorrect Payment(UCR)
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- 255
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by sonnybloom
Fri Dec 13, 2013 5:08 pm
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Multiple Endoscopic Rule
by bryank » Wed Feb 13, 2013 10:50 am
in Others
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- 49
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by bryank
Wed Feb 13, 2013 10:50 am
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CPT 95941 UPDATE
by APPEAL812 » Tue Feb 12, 2013 11:54 am
in Medical Necessity
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- 138
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by APPEAL812
Tue Feb 12, 2013 11:54 am
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No Prior authorization
by cathshops » Wed Nov 14, 2012 10:29 am
in Medical Necessity
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- 499
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by cathshops
Wed Nov 14, 2012 10:29 am
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Two reductions listed on the Explanation of Benefits
by lgreen » Fri Nov 09, 2012 10:03 am
in Refund/Recoupment
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- 144
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by lgreen
Fri Nov 09, 2012 10:03 am
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WC surgery was never billed from '09, claim is settled.
by drjmbones » Mon Oct 29, 2012 5:45 am
in Worker's Comp
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- 85
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by drjmbones
Mon Oct 29, 2012 5:45 am
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UHC Rejected-No Auth-Auth was for a different provider
by Claudia » Fri Sep 07, 2012 11:15 am
in Medical Necessity
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- 96
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by Claudia
Fri Sep 07, 2012 11:15 am
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Seeking Retroactive Precertification for Anesthesiology
by ttipton » Tue Jul 10, 2012 6:22 am
in Anesthesiology
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- 43
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by ttipton
Tue Jul 10, 2012 6:22 am
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Denial for Lack of authorization from network (primary care)
by realtime » Mon Apr 23, 2012 3:09 pm
in Timely Filing
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- 110
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by realtime
Mon Apr 23, 2012 3:09 pm
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paid at contracted rates when not contracted
by inlanduc0320 » Sun Apr 22, 2012 10:00 am
in Timely Filing
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- 94
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by inlanduc0320
Sun Apr 22, 2012 10:00 am
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Hospital-denied-no precertification-no auth-no notification
by JSMG5628 » Sun Apr 08, 2012 10:48 am
in Medical Necessity
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- 127
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by JSMG5628
Sun Apr 08, 2012 10:48 am
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Insurance information not provided at time of service
by medsupport » Thu Apr 05, 2012 11:59 am
in Timely Filing
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- 93
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by medsupport
Thu Apr 05, 2012 11:59 am
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MCR105 Rating system
by drmatt » Thu Mar 29, 2012 9:38 am
in Aetna
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- 34
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by drmatt
Thu Mar 29, 2012 9:38 am
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non-par with Oxford
by neuroaxis » Thu Nov 10, 2011 1:14 pm
in Others
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- 50
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by neuroaxis
Thu Nov 10, 2011 1:14 pm
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MD paid but the facility was not
by ASILLC » Fri Oct 28, 2011 11:59 am
in Medical Necessity
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- 80
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by ASILLC
Fri Oct 28, 2011 11:59 am
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infant claims
by karencoupe » Thu Oct 13, 2011 1:12 pm
in Aetna
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- 31
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by karencoupe
Thu Oct 13, 2011 1:12 pm
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Medicare 160
by karencoupe » Fri Sep 09, 2011 10:20 am
in Others
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- 38
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by karencoupe
Fri Sep 09, 2011 10:20 am
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BCBS of Texas fax number for appeals
by Mederi » Tue Aug 30, 2011 7:15 pm
in BC/BS
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- 64
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by Mederi
Tue Aug 30, 2011 7:15 pm
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BCBS UCR for California vs UCR Illinois
by acjlegal » Thu Aug 11, 2011 8:05 pm
in BC/BS
- 0
- 54
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by acjlegal
Thu Aug 11, 2011 8:05 pm
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Oxford
by kellyjack » Wed Jun 08, 2011 11:44 am
in Others
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- 33
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by kellyjack
Wed Jun 08, 2011 11:44 am
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AOB APPEAL LETTER FOR STATE OF UTAH
by BOBBI » Thu May 05, 2011 8:46 am
in Timely Filing
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- 28
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by BOBBI
Thu May 05, 2011 8:46 am
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Medicare HMO non participating physicians
by tpontillo » Tue Apr 26, 2011 12:45 pm
in Medicare
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- 41
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by tpontillo
Tue Apr 26, 2011 12:45 pm
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Liberty Mutual Denying stating not in the HCN Network
by Kristincl » Thu Feb 10, 2011 11:14 am
in Worker's Comp
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- 52
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by Kristincl
Thu Feb 10, 2011 11:14 am
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Must Listen For Chiros: BCBS v Chiros in Recoupment Lawsuit
by ttipton » Mon Feb 07, 2011 2:34 pm
in Chiropractic
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- 56
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by ttipton
Mon Feb 07, 2011 2:34 pm
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New Medicare Timely Filing Requirements
by ttipton » Fri Jan 14, 2011 3:34 pm
in Timely Filing
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- 94
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by ttipton
Fri Jan 14, 2011 3:34 pm
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New Podcast With D. Brian Hufford on recoupment litigation
by ttipton » Thu Jan 13, 2011 12:03 pm
in Litigation
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- 58
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by ttipton
Thu Jan 13, 2011 12:03 pm
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Care Core National / Horizon bundling radiology in New Jers
by SOCH1140 » Tue Jan 11, 2011 12:04 pm
in BC/BS
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- 40
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by SOCH1140
Tue Jan 11, 2011 12:04 pm
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Florida Work Comp underpayment
by gosb » Wed Dec 08, 2010 3:11 pm
in Worker's Comp
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- 31
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by gosb
Wed Dec 08, 2010 3:11 pm
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Thermal Facet Rhizotomies
by neuroaxis » Wed Nov 17, 2010 7:45 am
in Medical Necessity
- 0
- 33
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by neuroaxis
Wed Nov 17, 2010 7:45 am
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Liberty Mutual Work Comp Issues
by rvmcfs » Tue Nov 02, 2010 1:50 pm
in Worker's Comp
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- 79
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by rvmcfs
Tue Nov 02, 2010 1:50 pm
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DME Invoice request
by rsmedical » Mon Oct 25, 2010 12:32 pm
in Timely Filing
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- 37
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by rsmedical
Mon Oct 25, 2010 12:32 pm
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Nonpar doctor and timely filing
by smkconsultant » Fri Sep 24, 2010 11:02 am
in Timely Filing
- 0
- 127
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by smkconsultant
Fri Sep 24, 2010 11:02 am
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Need letter to refute payor for non-coverage policy
by ROBINSOND » Wed Aug 11, 2010 1:58 pm
in Medical Necessity
- 0
- 128
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by ROBINSOND
Wed Aug 11, 2010 1:58 pm
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TRICARE Bundling Codes
by kachina » Tue Aug 03, 2010 9:33 am
in Incorrect Payment(UCR)
- 0
- 75
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by kachina
Tue Aug 03, 2010 9:33 am
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Request for ERISA documents not answered
by WMIEnterprises » Tue Jul 20, 2010 11:36 am
in ERISA
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- 75
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by WMIEnterprises
Tue Jul 20, 2010 11:36 am
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New ERISA law pertaining to non-network checks
by WMIEnterprises » Mon May 17, 2010 1:24 pm
in ERISA
- 0
- 121
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by WMIEnterprises
Mon May 17, 2010 1:24 pm
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UHC denying interpretation for 76818-26 billed w/ 99219-25
by Brogang1 » Wed May 12, 2010 11:04 am
in United Healthcare
- 0
- 66
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by Brogang1
Wed May 12, 2010 11:04 am
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PROSTHETICS - CODES DENIED WHEN MORE THAN QUANTITY OF (1)
by prolimb » Thu Apr 22, 2010 7:03 am
in Aetna
- 0
- 33
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by prolimb
Thu Apr 22, 2010 7:03 am
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Aetna Discounts
by firstcall » Thu Mar 18, 2010 6:49 pm
in ERISA
- 0
- 95
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by firstcall
Thu Mar 18, 2010 6:49 pm
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Localized Hyperthermia denied for being experimenta...???
by lex5847 » Fri Feb 19, 2010 6:50 pm
in Medical Necessity
- 0
- 32
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by lex5847
Fri Feb 19, 2010 6:50 pm
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Auto Claims denied not related to accident
by HPTLLC » Tue Feb 09, 2010 4:48 pm
in Medical Necessity
- 0
- 56
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by HPTLLC
Tue Feb 09, 2010 4:48 pm
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Individual lines on an approved claim not paid HorizonBCBSNJ
by Lincoln913 » Mon Jan 18, 2010 3:49 pm
in Medicare
- 0
- 60
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by Lincoln913
Mon Jan 18, 2010 3:49 pm
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