Wiki Updated Order after Service has been Provided

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ejhahn

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Hi - I am needing input on this scenario: A patient presented to a Imaging Center for an MRI. The patient had the MRI, but when the claim was billed, it was denied that the referring provider is out of network with Medicare. The Imaging Center office is requesting that the referring physician be updated on the order (they obtained an updated script) to an in-network provider. I have stated that we cannot resubmit the claim because we can't accept an updated order after the service was provided. I am getting push-back and wanted to make sure I am correct in my statement. Any input is appreciated, thanks!
 
https://www.cms.gov/Outreach-and-Ed...gnature_Requirements_Fact_Sheet_ICN905364.pdf
In my opinion, this fits the definition of a retroactive order. CMS does not allow retroactive orders, "You can’t add late signatures to orders or medical records (beyond the short delay that happens during the transcription process). We don’t accept retroactive orders." I believe that most other payers have a similar policy.
 
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