Wiki Prior Auth for Echo

[urbach34@yahoo.com]

Has anyone been getting denials recently on their echos? My office bills only the professional component. We have been using the date that the cardiologist reads the echo, which is not matching up to the authorization for the date of service the echo is performed. We had not had problems in the past until prior authorizations were required. Our date of reading is not on the authorized date of service. How do we handle this?

 

[JayalakshmiF]

Generally authorization will not be getting on specific dates, it will be for an duration period they will get an authorization, the provider rendered the service with in the authorization duration period then there wont be any denail if auth date expires then need to get an reterouth for the service performed or else need to appeal with medical record to the Insurance.

 

[heartyoga]

Same boat

We are in the same boat. The hospital does the echo e.g. at night (9 pm) for inpatients and our doc reads it the next morning.


Typically I call the insurance and sometimes it works, sometimes it doesn't.

Good luck!