Hello,
I have an interesting issue. A family was provided a superbill for RTC level of care to BCBS of AZ for member reimbursement. It is Out of Network care and was denied at intake because they required 24hr nursing which was not at the facility at that time. Due to the 24hr nursing, I did not bill or do UR for this case.
Now, the superbill was denied and the family hired these healthcare billing specialists. They are now demanding that I provide them with UBO4 claims for this client. I explained that I would submit them directly to the carrier as a courtesy for the family/ my client but I will not provide claim forms to this third party advocacy ( who you think could fill out a claim form ). The advocacy firm woman is not happy. I asked if she has ever done any billing and her reply was, no she has not. She doesn't understand why I am submitting this to the carrier, as a courtesy and I won't provide her copies of the claim since I "just simply have to put the superbill info on the UB form"
Am I being difficult or how would you handle this so the family can get paid and I can not deal with these incompetent advocacy people. My concern is that not knowing anything about claims, but she claims to be an "appeal and denial specialist" that she is unable to speak to the claim denials for 24hr nursing and no prior authorization. She is simply doing what they are telling her based on what they understand of the situation.
My question- What Would You Do?
AND still keep your client happy.
