Wiki ABA billing with no Auth (cross posted)

[JWash618]

Is it standard practice to start billing ABA services to insurance companies before an authorization is issued? I thought that billing was not supposed to be done before an authorization was given, but I have been told to bill anyway, sometimes for several months before an authorization comes through. That way we could have proof that we have been billing so we can go back and appeal all of the denials. Is this correct?

In most cases these are being resubmitted after the auth comes in, and those months of provided services are still being denied again, for no auth.

I am getting resistance on trying to hold off billing until we get an auth.

Thoughts?

 

[khartoum1900nile@aol.com]

I do DME billing for Medicaid and we need a PA before the claim can be billed, otherwise, it will get denied for no PA, and can't retro the PA to cover those claims. I don't know if it is the same for ABA services, but it might be.

 

[JWash618]

I do DME billing for Medicaid and we need a PA before the claim can be billed, otherwise, it will get denied for no PA, and can't retro the PA to cover those claims. I don't know if it is the same for ABA services, but it might be.

That seems true for ABA, they will pay maybe 2 weeks prior but not the months prior that we have been re-billing. We have just been writing off those services and it doesnt make sense to me