sdflowers
New
We are getting denials for nerve blocks from out of area BCBS and other payers for "experimental/investigational". Does anyone have any suggestions as to how to get this treatment approved for payment with these payers?
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Wiki NERVE BLOCKS
- Thread starter sdflowers
- Start date
fradyk
New
If the insurance payor has a policy for nerve blocks and considers the services as experimental and investigational for the condition indicated, it is a non-covered service. No authorization will override this. There are measures to take to advise the patient before services are provided of the service being non-covered so the patient is aware of responsibility of cost for the service. Otherwise, the denial can be appealed but in most cases, they will uphold the denial.
jkyles
True Blue
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Hi there,
I agree that the policy for the specific payer should be the first place you check, but if you say which blocks you're billing it could help get an answer to your question.