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Michele:
I would make sure I explain to the patient that you are providing her with the form but that the person she hired is not understanding why the claim denied.  I would say that you hope that she is able to get the claim paid for them, but that she is not listening to why the claim was denied.

EZlabor:
That sounds fair and I GREATLY appreciate your input. It makes sense to just cut those healthcare advocacy people out. This "appeals and denials expert" is really sad. Poor family is paying her a portion or who knows what ..when she isn't qualified. Thank you again!

PMRNC:

--- Quote ---That sounds fair and I GREATLY appreciate your input. It makes sense to just cut those healthcare advocacy people out. This "appeals and denials expert" is really sad. Poor family is paying her a portion or who knows what ..when she isn't qualified. Thank you again!

--- End quote ---

I have to strongly disagree. It could be quite the opposite if this case is ERISA.


--- Quote ---claim denials for 24hr nursing and no prior authorization
--- End quote ---

Using ERISA if applicable I could do an appeal an get these claims paid, prior auth or not. <g>

EZlabor:
thank you. Their advocate does not know how to even simply fill out a claim but also state they are claim experts. I doubt erisa knowledge can help them....

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