I work for a neurologist who often gets called by the nearby hospitals for inpatient consultations.
Problem: We receive too many denials on our claims for these hospital inpatient consultations from the reponsible Medical Groups/IPA/HMO. The main reason for denial is NO AUTHORIZATION ON FILE.
Our office assumes the hospital or the referring doctor has already made an authorization request before our neurologist arrives. Some medical groups do reimburse responsibly, but there are a few medical groups that consistently deny our claims on this basis. Our neurologist is not contracted with these medical groups.
I am suspicious of these medical groups. Consistent denials are getting to be a problem.
Does anyone working for a specialist's office recommend a method to ensure these inpatient consultations do get paid responsibly by non-contracted medical groups?
Problem: We receive too many denials on our claims for these hospital inpatient consultations from the reponsible Medical Groups/IPA/HMO. The main reason for denial is NO AUTHORIZATION ON FILE.
Our office assumes the hospital or the referring doctor has already made an authorization request before our neurologist arrives. Some medical groups do reimburse responsibly, but there are a few medical groups that consistently deny our claims on this basis. Our neurologist is not contracted with these medical groups.
I am suspicious of these medical groups. Consistent denials are getting to be a problem.
Does anyone working for a specialist's office recommend a method to ensure these inpatient consultations do get paid responsibly by non-contracted medical groups?
