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Wiki Current Prevnar 20 Denials??

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Melissasuewashburn

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Location
Harvest, AL
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We haven't switched to PCV20 yet as we want to make sure all payers are covering before switching as we got burned on PCV15. Is anyone still having denials for Aetna, Cigna, UHC, TRICARE, or UMR?
 
Best to check the medical policies for the insurance plans. We waited till I was able to confirm per the policy that is was covered for the pediatric population. Aetna updated their policy 10/14/23, and UHC was updated I think a week or so before that. CIGNA was not an issue. If you pull the medical policy, you can even google it and if you get denials you can get them overturned with the proof from the policy. Sometimes the insurance dont update their claims system as quick as their medical policies update. We have not had any issue for payments. Hope this helps.
 
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