Wiki AOR forms

[Cavalier40]

Payers like UHC are requiring AOR forms (authorization of representative) forms to allow us to appeal for 3rd party lab claims. the ordering facility usually has an AOB and some have a specific authorization to appeal, but its for the facility, not the lab. Except for deductible an coinsurance billing, the lab does not have any contact with the patient. I am wondering if a 3rd party lab would be covered under an AOB for a facility if they are the ones who ordered the labs? Also are the authorizations to appeal worth anything, or are the insurance companies going to force a proprietary form?

 

[karamac]

Did the patient sign your requisition form for the testing? And does it contain language that will meet AOR requirements? When a laboratory has language specific to the assignment of benefits, and authorization to appeal in the patient signature section then as long as that patient signs the requisition, you should not have an issue. Are you not getting patient signatures?

If not this is not just a problem for appeals, if the patient were to state to Medicare or an insurer that it was not their specimen, you may have pay any funds related back. Signature on File is also not appropriate, the patient needs to sign that requisition. That is the best practice.