This question is for my Skilled Nursing Facilities billers out there - Has anyone received a denial from BCBS (specifically Michigan) citing a duplicate of service due to the fact that the plan guidelines only allow a maximum of 2 providers of any specialty to treat the patient per week?
We were given this denial reason by BCBS of MI and it is the first we've ever heard of it. We were also told that the claims are paid on a first come first served basis, therefore if 3 providers billed for services that week only the first 2 claims would be paid and all the rest would be denied.
We were given this denial reason by BCBS of MI and it is the first we've ever heard of it. We were also told that the claims are paid on a first come first served basis, therefore if 3 providers billed for services that week only the first 2 claims would be paid and all the rest would be denied.