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Wiki Global 9 mos out?

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PLAIDMAN

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I have received a denial for a procedure, the payor is stating that it is in global but the surgery was over 9 months ago?

Pt had acl reconstruction as well as mcl repair 9 months ago. And we recently billed for biopsies to check for infection as the patient has increasing issues with knee.



Anyone know what is going on with that? and how long would it apply?
 
Global surgical period

Have you tried calling the insurance company to explain in detail the denial.
If the patient has not had any other surgery other than the ACL 9 months ago, then the insurance company has definitely processed this claim incorrectly. You can do an appeal, but I still would try the telephone call first; that may be all it takes. Make sure and get the name of the customer service rep you talk with and possible a reference number on your phone call.

CW
 
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