Coding > Coding

Rapid Flu Test

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PMRNC:
That's not a denial based on WHAT you billed but rather the eligibility of the provider.

Michele:
It sounds to me like the provider doesn't have their CLIA waiver on file with Medicare.

Michele

redeyecherry:
OK thanks :D
i just appealed it with copy of the CLIA certificate - hoping it will finally go through now.
thanks a bunch for all the answers

Michele:
I'm afraid that won't be enough.  I think they will require that you complete a CMS application with the CLIA waiver info on it.  There is a place in the CMS form to indicate if a provider has a CLIA number.

Michele

redeyecherry:
ah ok, well we do have the CLIA number in every claim when we send it and it is only medicare that wont pay so i hoped that will help.
Off to calling medicare then

thanks again

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