Author Topic: Medicare Part B TX Denial ?  (Read 2102 times)

AllAboutU

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Medicare Part B TX Denial ?
« on: September 18, 2014, 08:43:31 PM »
Hey yall!!!

I have patients that just recently started denying by TX Medicare as "invalid, incorrect initial treatment date". The electronic claim is populated with 7/22/14 in the initial (date of injury) field and the two dates of svs being billed and denied are 7.29 and 8/5.

The software company says their software is fine and I should add dates to the date last seen and x-ray fields.

Novitas state they see the information on the electronic claim but really do not have a definitive answer as to what's causing the denials. I know a new LCD came out but it does not make mention of the injury dates, just that the patient is allowed 12 visits per year or 30 for continued care.

Has anyone else experienced this? Should I populate the other field's? I called another biller here and she's not experiencing this problem so she wasn't able to help.

Medicare is the lifeline of this company and it seems like right when things are going right...... they end up going left


Thank you for your help and feedback

rdmoore2003

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Re: Medicare Part B TX Denial ?
« Reply #1 on: September 19, 2014, 09:10:53 AM »

Novitas state they see the information on the electronic claim but really do not have a definitive answer as to what's causing the denials.



So what has Novitas said they are doing to look into this.
Regina

Michele

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Re: Medicare Part B TX Denial ?
« Reply #2 on: September 19, 2014, 12:46:08 PM »

Novitas state they see the information on the electronic claim but really do not have a definitive answer as to what's causing the denials.



So what has Novitas said they are doing to look into this.

My thoughts exactly.  They are denying the claims stating that information that they say is present, is not there.   ???
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AllAboutU

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Re: Medicare Part B TX Denial ?
« Reply #3 on: September 20, 2014, 07:28:10 AM »
Medicare sent the claims back as a verbal appeal which should take 4-6 weeks to reconsider. I haven't gotten a clear answer from any rep about the denials. In the meantime I'm not sure what is happening. Has anyone else gone through this?

Thank you

AllAboutU

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Re: Medicare Part B TX Denial ? UPDATE
« Reply #4 on: September 20, 2014, 08:15:12 AM »
I am in the process of moving my billing to office ally. I thought maybe the denials were because of the software I am currently using. SOOOO I billed a test claim through office ally to Medicare on 9/8 claim denied on 9/12.... same denial invalid missing or incorrect initial treatment date :-(

Merry

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Re: Medicare Part B TX Denial ?
« Reply #5 on: September 21, 2014, 08:12:15 PM »
Just curious. Is this a general med practic or therapy services or chiro?

AllAboutU

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Re: Medicare Part B TX Denial ?
« Reply #6 on: September 23, 2014, 11:58:00 PM »
Mary it's Chiro only