I need help. My doctor saw patient in the hospital for late syphilis, latent. MCO has denied claim for auth. I called payer who said they never received the facility claim. Then I called facility and rep said because patient was admitted due to psych issues, facility has billed to Bhv plan of the state. I know that Physician will not get paid by Bhv payer. Do I have any chances to get paid after appeal with MCO?
Thanks