BCBS claim edits
Bonni Wilke
Description
Collection
Title:
BCBS claim edits
Creator:
Bonni Wilke
Date:
2/6/2018
Text:
Hi Listserv,
We are curious as to whether or not other providers are experiencing issues with BCBS paying for a quantity of more than 1 L5673.
Beginning in August, when we filed a claim for L5673 x 2, BCBS is denying the service with the reason that the patient has exceeded their daily limit for liners...meaning they cannot receive 2 liners on the same day.
We have been told by multiple BCBS representatives that these claim edits are following the CMS LCD which is not true. We have filed reconsideration's for all of our denied claims, however, we have not received any response yet on these reconsideration requests.
I recently had a phone call with our contracting specialist who was not any help.
Has anyone else experienced this issue recently?
Thank you,
Bonni Wilke
Office Manager
Precision Prosthetics, Inc
1505 S Perkins Rd
Memphis, TN 38117
p. 901.682.1006
f. 901.682.5775
We are curious as to whether or not other providers are experiencing issues with BCBS paying for a quantity of more than 1 L5673.
Beginning in August, when we filed a claim for L5673 x 2, BCBS is denying the service with the reason that the patient has exceeded their daily limit for liners...meaning they cannot receive 2 liners on the same day.
We have been told by multiple BCBS representatives that these claim edits are following the CMS LCD which is not true. We have filed reconsideration's for all of our denied claims, however, we have not received any response yet on these reconsideration requests.
I recently had a phone call with our contracting specialist who was not any help.
Has anyone else experienced this issue recently?
Thank you,
Bonni Wilke
Office Manager
Precision Prosthetics, Inc
1505 S Perkins Rd
Memphis, TN 38117
p. 901.682.1006
f. 901.682.5775
Citation
Bonni Wilke, “BCBS claim edits,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/208681.
