Wiki Health Plan denies as group responsibility

aleigh

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Hi,
I come across denials (mostly from Health Net) where they are denying the services because they are responsibility of the member's medical group. Then the medical group is denying them as Health Net responsibility. I'm trying to figure out the fastest way to tackle this issue that doesn't involve me wasting time on a group call with Health Net, and the group.
Does anyone have a successful way of dealing with this? I know the error is on Health Net's end, just an appeal with the medical group denial? It's a very frustrating, unnecessary delay in payment. I appreciate any insight.
 
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