Medical Billing Forum
Billing => Billing => : MacCG March 30, 2022, 07:34:30 PM
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Hi, I work in a counseling office and submit mental health outpatient claims. This is the first time I've ever had a denial come back from BCBS with the explanation of denial *Benefit Covered only if provided or ordered by primary care physician or medical group. Any suggestions? I have a hard time actually speaking with a customer representative because I keep getting the automated system. Any help is greatly appreciated!
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Sounds like an authorization or referral is needed and is absent. Do you have auth or a referral? If so, I would resubmit with that information.