Payer stating change the order of icd10 on ltc/snf

jenncode

Guest
Messages
1
Best answers
0
Here in Chicago a medicaid payer is telling us to change the order of ICD10 to receive payment. My argument is that their system is not setup for Aftercare to post acute/snf/ltc. Being we have to obtain a authorization. I have made this a level up from their regular claims adjuster. Please help!
 

cgaston

Expert
Messages
494
Location
Clarence, NY
Best answers
0
So are you saying that if you change the order to what they are requesting they will pay it?

Or is it that you will need to obtain prior authorization if you switch it to the order they are requesting?

I have had experiences with "overzealous" Claim Representatives requesting things out of the blue. No matter how many time you point out that you've had these issues before and you never had to provide "X" they are relentless regarding whatever they are requesting. I always "played the game" and provided what was requested. Sure, it doesn't seem right but my provider doesn't care if I am "right" he cares if I am getting his claims paid.

Very often you will get two different answers from two different Claims Representatives, so hopefully you will get a different answer from the next Representative. Or you can request the authorization from them at least! ;)

(this is just my humble opinion)
 
Messages
811
Best answers
0
Is this one of those state transitional or family and children assistance programs? :\ Oh how I love MD of IL. :rolleyes:
 
Top