sjooemmy08
Networker
Good morning, I work for an FQHC in Orange County, SoCal.
I have been billing for O/P wrap with prior authorization numbers included in the claims and
they started to deny the reimbursement starting last March.
So here are the details of the claims.
I bill 99245, with referral number, and referring provider information.
Then they deny the reimbursement with code CO-109 which is for the absence of the referral.
I printed the form and made sure the referral number is stated in the claim and
even left memos that say "pre-auth number xxxx."
I also tried sending paper forms by mail, and they sent it back because it was misaligned, or missing 001
at the final charge line, etc. They were there, but off by half of a line due to a printer setting problem.
One of the billing software technicians had to work on this misalignment with me for three hours
and the best we could get was denied still....
Does anyone know where to call in to ask about this?
I have been billing for O/P wrap with prior authorization numbers included in the claims and
they started to deny the reimbursement starting last March.
So here are the details of the claims.
I bill 99245, with referral number, and referring provider information.
Then they deny the reimbursement with code CO-109 which is for the absence of the referral.
I printed the form and made sure the referral number is stated in the claim and
even left memos that say "pre-auth number xxxx."
I also tried sending paper forms by mail, and they sent it back because it was misaligned, or missing 001
at the final charge line, etc. They were there, but off by half of a line due to a printer setting problem.
One of the billing software technicians had to work on this misalignment with me for three hours
and the best we could get was denied still....
Does anyone know where to call in to ask about this?