- Joined
- May 26, 2010
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Just a quick tip. I've discovered a new trick I've been seeing from Anthem. I think it's AIM specialty care that runs their initial prior auths. If they deny and you appeal through anthem be careful if you receive approval from an overturn from their grievances and appeals department. They still denied my scs trial and now an LESI.
It took me over 3 months to finally figure out how to get paid on the scs trial and I just resubmitted the LESI. The trick to getting paid is to ask to speak with the medical management department and then to a nurse in that department. Then respectfully request the nurse to kindly extend the span date to the day after you performed the procedure.
Going forward, I'm going to take the approval from the overturn letter and call Anthem again prior to the procedure. I'm going to confirm approval with updated span dates and cpt codes and document everything. Hopefully, that will help prevent denials.
We should keep a running list of ways the payers are denying and how to successfully get them overturned.
It took me over 3 months to finally figure out how to get paid on the scs trial and I just resubmitted the LESI. The trick to getting paid is to ask to speak with the medical management department and then to a nurse in that department. Then respectfully request the nurse to kindly extend the span date to the day after you performed the procedure.
Going forward, I'm going to take the approval from the overturn letter and call Anthem again prior to the procedure. I'm going to confirm approval with updated span dates and cpt codes and document everything. Hopefully, that will help prevent denials.
We should keep a running list of ways the payers are denying and how to successfully get them overturned.
