Wiki Molina Underpayments

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Rapid City, SD
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Are other providers having an issue with Molina underpayments in any state? We have had claims underpay 99214 as if it was a 99213, and when we asked Molina about it, we were referred to this 2020 bulletin: https://www.molinahealthcare.com/~/.../2020-07_Provider_Bulletin_final_for_Comm.pdf

On August 1, 2020, Molina will be implementing a program to evaluate and review high-level Evaluation and Management (E/M) services for practitioners that appear to have been incorrectly coded based upon diagnostic information that appears on the claim and peer comparison. The following are example remittance messages which may be included on, but are not limited to, future E/M claims processed
• Line [X] Service Code ‘99204, 99205, 99215, 99214’ visit level lowered to ’99203, 99204, 99213, 99214’.
• This claim line was processed using a code that more accuratelyrepresents the treatment received.
• The information submitted on the claim does not support the codeoriginally billed. The provider has been reimbursed using the level[insert level] Evaluation and Management code which more appropriately supports the information submitted on the claim.
Payer deems the information submitted does not support this level of service.
• Alert: Payment based on an appropriate level of care.
If you disagree with Molina’s findings after this review, you have the rightto appeal the decision. Please follow the standard claim reconsideration process indicated in your Provider Manual.

Why not deny for medical records if payer needs supporting info to reimburse that level of service? I have asked for more information and justification for this policy, and I am waiting on a response. The only reason we found it is because our claims management system has rules set up to find underpaid claims. Otherwise this would not have been detected as our paid claims rarely get review. We process tens of thousands of claims a month.

If you've had this happen, please let me know!
 
This is a ploy to save revenue that several insurance companies are using, not sure how ethical it is to be changing codes when you haven't read any records. The AMA needs to get on this. They are preying on offices not having enough time and staff to appeal these and just accepting what they pay. I appeal all of them with the office note attached. If you read your office note and feel their coding is correct, move on to the next one. If you don't appeal anything they will just keep doing it.
 
This is a ploy to save revenue that several insurance companies are using, not sure how ethical it is to be changing codes when you haven't read any records. The AMA needs to get on this. They are preying on offices not having enough time and staff to appeal these and just accepting what they pay. I appeal all of them with the office note attached. If you read your office note and feel their coding is correct, move on to the next one. If you don't appeal anything they will just keep doing it.
Can I ask what state your provider is based out of?
 
Google Molina underpaying providers--they are doing it in lots of states. Again I question if changing a CPT code is ethical when you have not reviewed any documentation pertaining to the visit especially with the current coding guidelines. I could see a patient for an ear infection who has other complicated health issues that required me to review all her medications, prescribed a new antibiotic for her ear and discussed an ear surgery which would be a level 4 but my diagnosis code on the encounter was for otitis media and eustachian tube dysfunction. Does that mean it's ok to reduce my visit to a level 3? Molina has no idea what went on in the visit or what medical decision making was involved. They can't reduce a visit because they don't like the diagnosis code, but they are and hoping you don't appeal it.
 
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