Becker's Healthcare August 29, 2024
As some areas see an uptick in post-procedure claim denials from payers, ASCs may be at a loss on how to salvage payments.
Becker’s connected with Amy Chamberlin, BSN, RN, nurse care manager and clinical denials specialist at Binghamton, N.Y.-based United Health Services Hospitals, to find out what can be done when faced with post-procedure denials.
Editor’s note: Response has been edited lightly for length and clarity.
Question: What should be done when payers deny procedures?
Amy Chamberlin: I can see post-procedure denials for multiple reasons. One being no authorization, which could be for multiple reasons, such as simply neglecting to get prior authorization, getting authorization for the wrong CPT codes or in a situation when you previously got...
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