Wiki Denial for No Auth? can anyone help?

[ShawnaB01]

I recently have been getting denials for no auth being obtained from the office where services have been rendered. It's not possible to get a back dated auth. Does anyone have a good appeal template for this? Im new to the billing field, so any feedback would be very helpful.

 

[zaidaaquino]

No Auth Denials

I don't have a template, but when I attempt an appeal I acknowledge in the appeal that we know we didn't get an authorization. I request that the claim be reconsidered based on medical necessity. That being said, some insurances consider a "no authorization" denial to be an administrative denial. In those cases, they will not consider based on medical necessity.