Wiki Non par denial

mieka.schambach

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Knoxville, TN
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So I have a provider. He was not credentialed with MCR (he now is, but not for those DOS), however he was seeing medicare patients. Therefore he was getting a non par denial. Is there any way to get these paid?
 
Just went through this at my site. According to my MAC, you can backbill 30 calendar days before the approval date on the provider's "PTAN letter." Anything before that is a write-off
 
I would do a batch appeal with the claims, the Medicare Remittance Reports showing the denial and with a letter to reconsider due to the credentialing issues...maybe contact your MAC provider relations and ask how they want to see this done.
 
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