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PMRNC:
What do you mean your not a brain surgeon?? come on now!

rdmoore2003:
yes thank you.  Linda, what are your thoughts with Valueoptions? Do you have issues with them precerting requested psych testing?

PMRNC:
I used to do a lot of Value Options, but now it's dropped off significantly. We do have to get authorizations for psych testing and they will only authorize one on a day w/no therapy.

rdmoore2003:
Linda, the issue we are having with Valueoptions is if we request say 3 units of testing, they never give us that.  Even with their list of testing, our units are mostly equal to their units per test and we still don't get the total hours requested.  To appeal, we have to contact them, wait for them to send a form to us in the mail, then the patient has to come to the office to sign, then we have to mail it back to them just to start the process.   Does this sound familiar?

PMRNC:
Hmm, I don't have an issue because the provider does them on different days for that reason. They will only authorize one unit per test per day. We have a few other carriers that do same thing which is why it's just better to give them diff appts. The good thing is that breaking it out doesn't mean it will go towards the MH maximum as long as your just doing testing that day. I went back and looked and right now currently I only have ONE active Value Option case and we did testing about 7 months ago.. 3 different dates and the authorizations are different. (3 authorizations). Everything was paid.

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