AMADDOX
Contributor
I work for a pediatric therapy clinic that performs "home-based" treatments. We are not a home health agency, but do go to patient's homes to perform services if they are unable to come to the clinic. My issue is that BCBS will not give us a pre-cert for POS 12 since we are not a home health agency, they tell us that we do not need a pre-cert, but when we bill our services as POS 12 they deny the claims stating that we are unable to perform in this POS due to the fact that our therapist's NPI#'s are not registered as home health. Has anyone else experienced these same issues and if so was there any resolution? We are the only clinic in our area who will go to these patient's homes and we want to find some way to continue to see these kids and get payment from BCBS. Any help would be greatly appreciated.