mmyoung
Guest
Good morning.
Long story short as short as possible: almost three years after the initial 2019 bills were paid by our CMS DME MAC they submitted recoupment notifications for several bills of HCPCS code L0637. Upon review of the recoupment notifications I realized our biller then had submitted the wrong code, then submitted corrected claims for HCPCS code L0650. Some of these have since paid.
There is one, however, I cannot get addressed by the payor. They are refusing to recognize the claim or any requests for redeterminations because the patient has, within the last three years, moved to a different jurisdiction (Arizona). For the date of service in question the patient lived in Texas.
I would love suggestions on how to address this issue, especially if you've been through something similar.
Thank you.
Long story short as short as possible: almost three years after the initial 2019 bills were paid by our CMS DME MAC they submitted recoupment notifications for several bills of HCPCS code L0637. Upon review of the recoupment notifications I realized our biller then had submitted the wrong code, then submitted corrected claims for HCPCS code L0650. Some of these have since paid.
There is one, however, I cannot get addressed by the payor. They are refusing to recognize the claim or any requests for redeterminations because the patient has, within the last three years, moved to a different jurisdiction (Arizona). For the date of service in question the patient lived in Texas.
I would love suggestions on how to address this issue, especially if you've been through something similar.
Thank you.