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Prior Auths for inpatient surgeries

  1. #1
    Question Prior Auths for inpatient surgeries
    Medical Coding Books
    I was just advised yesterday that our billing company is getting rejections on inpatient surgeries due to no prior auth. Apparently we always used the hospitals prior auth and it was fine. Now they are starting to kick those back.

    Is anyone else having this happen?


    Laura, CPC, CEMC

  2. #2
    Yeah this happens sometimes. Sometimes the hospital will also get the wrong dates so the auth doesn't match the surgery date or admission date. I know if we get denials for Blue Cross for no preauth, 8 times out of 10 either the pre auth date is wrong or the date of service provided by the practice was wrong.

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