Experimental/Investigational
Paula Rogerson-Doherty
Description
Collection
Title:
Experimental/Investigational
Creator:
Paula Rogerson-Doherty
Date:
10/10/2018
Text:
Hello List,
Looking for input on fighting experimental/investigational denial.
We are working to get L6880 approved and so far the insurance company is sticking to their denial for experimental/investigational.
We provided studies, provided Medicare coverage information, medical necessity, etc. - we don't feel they are even looking at anything just sticking to their policy that they classify this code as experimental/investigational there for does not meet guidelines. We have picked apart their policy and can make points to meet all other criteria - which we have done but they are sticking to original denial of experimental/investigational are not covered.
We are going to next level outside appeal and wondering if anyone has any information they have used for L6880 to argue against this denial.
Thank you
Paula Rogerson-Doherty
Business & Administrative Manager
Rogerson Orthotics & Prosthetics
P:(617) 268-1135
F(617) 269-3373
www.rogersonoandp.com
Confidentiality Notice: This email, including attachments, is covered by the Electronic Communications Privacy Act, 18 USC 2510-2521, and the HIPAA privacy regulations and, as such, is confidential and may be legally privileged. It is intended for the use of the individual or entity to which it is addressed and may contain certain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this email is not the intended recipient or agent responsible for delivering or copying this communication and attachments, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. Please reply to the sender that you received it in error, then delete it. Thank you for your cooperation.
Looking for input on fighting experimental/investigational denial.
We are working to get L6880 approved and so far the insurance company is sticking to their denial for experimental/investigational.
We provided studies, provided Medicare coverage information, medical necessity, etc. - we don't feel they are even looking at anything just sticking to their policy that they classify this code as experimental/investigational there for does not meet guidelines. We have picked apart their policy and can make points to meet all other criteria - which we have done but they are sticking to original denial of experimental/investigational are not covered.
We are going to next level outside appeal and wondering if anyone has any information they have used for L6880 to argue against this denial.
Thank you
Paula Rogerson-Doherty
Business & Administrative Manager
Rogerson Orthotics & Prosthetics
P:(617) 268-1135
F(617) 269-3373
www.rogersonoandp.com
Confidentiality Notice: This email, including attachments, is covered by the Electronic Communications Privacy Act, 18 USC 2510-2521, and the HIPAA privacy regulations and, as such, is confidential and may be legally privileged. It is intended for the use of the individual or entity to which it is addressed and may contain certain information that is privileged, confidential, and exempt from disclosure under applicable law. If the reader of this email is not the intended recipient or agent responsible for delivering or copying this communication and attachments, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. Please reply to the sender that you received it in error, then delete it. Thank you for your cooperation.
Citation
Paula Rogerson-Doherty, “Experimental/Investigational,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 5, 2024, https://library.drfop.org/items/show/209176.
