michele.como
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Hello,
I am billing post-op cataract care claims to commercial insurances like Blue Cross or Harvard Pilgrim but the claims continue to deny for timely filing. The optometrist is taking over the care from the surgeon which per guidelines we are billing with the surgery date as the date of service and the date she assumed and relinquished the post-op care is noted on the claim form. Since she is seeing the patient for the post-op period the claims are billed after the 90 days post op period which is causing the insurance to deny the claims for timely filing. I have sent appeals explaining that it is post-op care so she is seeing the patient for the post-op period and sent guidelines from Medicare about billing for the post-op care but the initial round of appeals upheld the timely filing denial. Any suggestions would be appreciated as to how to bill the post-op care claims to commercial insurances to avoid the timely filing denial or is the submission of these claims different from how we would need to submit the claims to Medicare? Any help would be appreciated. Thank you.
I am billing post-op cataract care claims to commercial insurances like Blue Cross or Harvard Pilgrim but the claims continue to deny for timely filing. The optometrist is taking over the care from the surgeon which per guidelines we are billing with the surgery date as the date of service and the date she assumed and relinquished the post-op care is noted on the claim form. Since she is seeing the patient for the post-op period the claims are billed after the 90 days post op period which is causing the insurance to deny the claims for timely filing. I have sent appeals explaining that it is post-op care so she is seeing the patient for the post-op period and sent guidelines from Medicare about billing for the post-op care but the initial round of appeals upheld the timely filing denial. Any suggestions would be appreciated as to how to bill the post-op care claims to commercial insurances to avoid the timely filing denial or is the submission of these claims different from how we would need to submit the claims to Medicare? Any help would be appreciated. Thank you.