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Treatment Authorization code for home health

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Catresej:
Hi,

Can anyone please tell me an easy way to create or get the treatment authorization code to bill for home health care because the insurance has denied the claim over not having it.  I heard it has 18 characters and we are an out of network provider.

Thank you, kindly

Michele:
I believe you are looking for a treatment authorization number?  It sounds like the patient's plan doesn't allow out of network benefits.  A treatment authorization number would be obtained prior to treatment by an in network provider.

Giver100:
Thank you for responding.  Yes, we are out of network but the client insisted to use us.  So, after weeks of disputing the insurance approved the services and they gave us an authorization number but I guess it's not the same number?  The insurance is Humana medicare.  How can I go about getting this because they sent us approval and said they will pay us and act as if it's no problem the whole time.  Can you please tell me what we should do? As I said, I have an authorization number that isn't 18 characters long. They mentioned looking at the OASIS manual to figure it out.

Thank you, kindly

Michele:
I have not heard of this before and honestly I thought you were getting a run around, but then I read this:  http://kb.barnestorm.biz/KnowledgebaseArticle50551.aspx 

It shows that the treatment authorization code does come from OASIS.  I'm hoping that link will help you find out how to get the number.

Giver100:
It is not a skilled nursing case so can Humana have the rights to not pay us without the treatment authorization code?  The service code is G2099 that was given as well as diagnostic R68.89.

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