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Payor requesting technologist W-2s

  1. Default Payor requesting technologist W-2s
    Medical Coding Books
    Has anyone heard of something like this before? One of the large commercial payors has been demanding increasing amounts of documentation before they'll process our claims for tests. Up to this point they've wanted us to send in things like signed notifications of privacy practices, raw data, etc., and demanded that we put in specific documentation, including technologist name & credential. This week, however, one of my billers checked on several that had not been paid and was told that they cannot be processed without a W2 from each technologist, so that the payor can "verify that they're actually employees of your company".

    This request seems above and beyond anything that could be considered necessary to process a claim, and I don't feel comfortable violating our technologists privacy. Before we get our attorneys involved, does anyone have any experience with a situation similar to this one?

  2. #2
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    Quote Originally Posted by adbuck View Post
    Has anyone heard of something like this before? One of the large commercial payors has been demanding increasing amounts of documentation before they'll process our claims for tests. Up to this point they've wanted us to send in things like signed notifications of privacy practices, raw data, etc., and demanded that we put in specific documentation, including technologist name & credential. This week, however, one of my billers checked on several that had not been paid and was told that they cannot be processed without a W2 from each technologist, so that the payor can "verify that they're actually employees of your company".

    This request seems above and beyond anything that could be considered necessary to process a claim, and I don't feel comfortable violating our technologists privacy. Before we get our attorneys involved, does anyone have any experience with a situation similar to this one?
    That is a new one to me!! Do you have a provider relations representative for that commercial payer? If you do, I would start there. Otherwise, you may need to get some legal advice before proceeding.
    Arlene J. Smith, CPC, CPMA, CEMC, COBGC

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