Author Topic: UHC Community Plan for Families  (Read 177 times)

Chiro Billing Collect

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UHC Community Plan for Families
« on: August 25, 2021, 04:57:08 PM »
Up until July 2021, this plan covered spinal manipulation (98940 & 98941) for anyone under 21 and with authorization. As of recently, they have been denying these codes stating that it is not a covered service. I have sent reconsiderations and they were all denied for 3 patients with this plan. We had auth for all of the visits as well. I spoke with a UHC rep who could not give me any info and told me to "do some research on my own." Does anyone have any insight on this change in policy for UHC Community Plan for Families? It is a medicaid plan but they had been covering chiropractic. These same patient even had paid visits in June, all billed the same exact way.

Michele

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Re: UHC Community Plan for Families
« Reply #1 on: August 28, 2021, 02:15:15 PM »
Well if it is not a covered service then why did they give authorization?  Did the plan change after the authorization was requested?  Personally the "do some research on your own" comment would have put me over the edge.  Just saying.  Quite honestly, they should be able to answer you.  Sounds like they don't want to do their job.  Have you tried more than one phone call?  I think you have two options:

1.  Call back and get another person.  Ask if something recently changed with the policy.

2.  Sent a written appeal with a copy of the authorization stating that the services were given a pre-authorization.

I would probably do the first option because it sounds like something may have changed with the policy and that would be the job of the customer service rep to be able to advise you.

Good luck!
 
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Re: UHC Community Plan for Families
« Reply #1 on: August 28, 2021, 02:15:15 PM »