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Wiki BCBS Medicare HMO

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shortee3810

Networker
Messages
43
Location
Raleigh, NC
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Can anyone give me some insight on billing hand splints for BCBS Medicare HMO? Below BCBS Medicare HMO does not require authorization if DME under $1200 but when we bill them for splints which is way under $1200 they do not pay for them. The EOB comes back with "consult plan benefit documents/guidelines for information about restrictions for this service... We have patient to sign waiver just in case they do not pay. Any suggestions will be greatly appreciated.



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