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Wiki Medical Necessity
- Thread starter lkerrison
- Start date
RebeccaWoodward*
True Blue
With a waiver of liablity of file? You should be able to-
Without a waive on file-This might depend on your carrier. Without a waiver of liability on file, some carriers may make this provider responsibility. It depends on the language within your contract.
I am curious though...The provider thought it was medically necessary to perform the test yet the carrier denied. What carrier is this? Most have a policy on file for NCS. Are you sure it can't be appealed?
Without a waive on file-This might depend on your carrier. Without a waiver of liability on file, some carriers may make this provider responsibility. It depends on the language within your contract.
I am curious though...The provider thought it was medically necessary to perform the test yet the carrier denied. What carrier is this? Most have a policy on file for NCS. Are you sure it can't be appealed?
jgf-CPC
Guest
Did it possibly need a pre-authorization? Did the patient also have an E&M with these services where it might have needed a 25 mod?