suki_26
Networker
Does anyone have any definitive answers as to what this is?
We started seeing these denials a couple months ago ... at first 1 lab code and now we are seeing more.
I have contacted Emblem and the customer service department has no idea what this is.. they are reading off scripts anyway. I have spoken to several supervisors and they can not give me a straight answer either just go to the link provided.
GHI is notorious for picking random codes and denials and running with it for a few months and then they pick another code. I'm afraid this new denial is going to be their catch all denial. I have looked through pages and pages of this new "Laboratory Management Program Reimbursement Policy" and all I see is a lot of fluff.
Supervisors have sent several claims back for "further clarification" with no luck. We get the general letter "claim was processed correctly"
Is anyone else paying attention to this? No way we can be the only office getting this denial.
We started seeing these denials a couple months ago ... at first 1 lab code and now we are seeing more.
I have contacted Emblem and the customer service department has no idea what this is.. they are reading off scripts anyway. I have spoken to several supervisors and they can not give me a straight answer either just go to the link provided.
GHI is notorious for picking random codes and denials and running with it for a few months and then they pick another code. I'm afraid this new denial is going to be their catch all denial. I have looked through pages and pages of this new "Laboratory Management Program Reimbursement Policy" and all I see is a lot of fluff.
Supervisors have sent several claims back for "further clarification" with no luck. We get the general letter "claim was processed correctly"
Is anyone else paying attention to this? No way we can be the only office getting this denial.