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UHC all denial reason and solutions
Sivakumar:
--- Quote from: PMRNC on January 24, 2013, 05:33:38 PM ---
--- Quote ---we can see remit codes and reasons in the eob.. but i don't know what is the appropriate action for the denial (ex: provider not eligible to perform this service ) this is one of the denial which i receiving from UHC often. even the provider is participated with the payer.
--- End quote ---
Richard gave you good overview of how denials work. I have to ask though.. Have you CALLED UHC? THAT denial ( provider not eligible to perform this service) tells me that the provider is proving a service outside the scope of their license to which this carrier has set. It could be state law. Without knowing procedure, type of provider and their licensing it's too hard to guess. MY first thought would be to contact the carrier directly and just flat out ask them if it wasn't obvious to me. Are you by any chance "offshore"? That might contribute to the lack of education regarding state/federal licensing requirements in the US. Sorry, I had to ask the obvious.
--- End quote ---
yes I am "offshore".. that is the reason i am not much familiar with us law and regulations.. but i am completed CCAT certifications successfully..
I did not check with UHC rep.. I'll talk them and let u know the reason for the denial..
Really thanks for your assistance..
RichardP:
now i just got an idea how to find out the solution..
Lightbulbs. That is what some of us are trying to do here - turn on lightbulbs.
PMRNC:
Over and out on this.. All yours ;)
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