AMADDOX
Contributor
I do billing in Texas for LSA's (licensed surgical assistants) who are able to file independently to many insurances and get paid. We have always filed and received payment from Humana in the past. Even the Medicare Replacment plans would send us agreements to sign stating we accept assignment and would only bill their
members the allowed amounts. Just today I started getting refund requests for the entire paid amounts for all of these claims. They are now stating that per the CMS guidelines LSA's are not a payable provider. Anyone else having this happen? Someone of these claims are 1-1 1/2 years old. Any advise on ways to fight this? Humana clearly knew the providers credentials, as well as all the claims had the appropriate AS modifier. I'm at a loss.
members the allowed amounts. Just today I started getting refund requests for the entire paid amounts for all of these claims. They are now stating that per the CMS guidelines LSA's are not a payable provider. Anyone else having this happen? Someone of these claims are 1-1 1/2 years old. Any advise on ways to fight this? Humana clearly knew the providers credentials, as well as all the claims had the appropriate AS modifier. I'm at a loss.