Good Afternoon,
I have a question about compliance, Our Nuclear Med and Ct department have been putting in orders but our Epic system Auto Auth certain HMO referrals.
When our tech perform the services the cpt code may change ,so they have been correcting the cpt code and sending the claim to our HPS department to verify and process everything before our claims are submitted to the insurance company. Our utilize management team is stating by us changing the cpt on the referral after it Auto Auth we are conducting fraud.... Now I know bill the wrong cpt code and preforming another cpt is fraud , so I am just trying to clarify this referral issue.
Need Help Please . .
I have a question about compliance, Our Nuclear Med and Ct department have been putting in orders but our Epic system Auto Auth certain HMO referrals.
When our tech perform the services the cpt code may change ,so they have been correcting the cpt code and sending the claim to our HPS department to verify and process everything before our claims are submitted to the insurance company. Our utilize management team is stating by us changing the cpt on the referral after it Auto Auth we are conducting fraud.... Now I know bill the wrong cpt code and preforming another cpt is fraud , so I am just trying to clarify this referral issue.
Need Help Please . .