Medical Billing Forum
Billing => Facility Billing => : gbhjk March 10, 2023, 04:13:07 PM
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I do inpatient mental health billing and recently started getting denials from Optum. They give authorization for People's Health advantage plan and at each utilization review the authorization numbers change by 1 number (xxxxx-01, xxxxx-02, xxxxx-03, etc.)
Now when I go to bill a stay, I get denied because I can only put 1 auth number on the claim but that number only covers a partial of the stay.
I have tried putting just the main number and excluding the last 2 numbers behind the dash. I have tried using only the first and using only the last auth number. I don't know what else to do. I'm not very experienced in this type of billing so any advice is appreciated.
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It sounds like the issue might be related to how Optum splits authorizations by review period. Usually for inpatient billing, you need to bill each portion of the stay with the specific auth number that covers those dates. Double-check the authorization ranges and match them to the claim span. If needed, try splitting the claim so each billed section uses the correct auth reference. You can also reach out to Optum’s provider support for clarification. Meanwhile, you can check this (https://lucky101.io/) for more helpful resources.