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Thread: UHC Pre-Authorization

  1. #1

    Exclamation UHC Pre-Authorization

    AAPC: Back to School
    Is there any possible way of getting United HealthCare to retro a pre-authorization?

    The Situation:
    Patient is being seen for physical therapy. For some unknown reason, the office did not obtain a pre-authorization. The claim was denied for not having a pre-authorization. As the billing company, we will not be paid for SEVERAL dates of service due to fault of the office.

    Does anyone know of any way to approach this or any type of loop hole that UHC has that may help my situation??

    Any thoughts or suggestions are greatly appreciated!!
    Tracey Thompson, CPC, CPPM

  2. #2

    Default maybe...

    hi, i dont know about UHC in general, but it does help to call up nicely, and speak with someone; explain the circumstances, ex: was it a holiday, vacation, sickness, etc; these things happen; you may have to take a penalty of some kind but it is better to get some payment than no payment; also lastly you may have to do an appeal or help the member with one as it is still the member's fault, they should know what type of insurance they have and what requires pre auth or not; hope this helps..

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