Newsletter: July 18, 2022

Denial codes result in a loss of revenue!

One of the benefits of working with The Glaeser Group is having a network of knowledge and experience to ensure you receive the maximum reimbursement possible. These weekly up-to-date newsletters are to help spread the information we receive from insurance companies and vendors. We invite you to forward us information you think may be helpful to other members of our network to info@theglaesergroup.com.

How to Prevent This Common Denial with One Easy Step

Common Denial Codes

One of the most common reasons for denials for pediatrics and PCPs can be tricky to work with. The denial codes CO-8, CO-38, & CO-197 are essentially due to the patients not having you listed as their primary provider. This is most common with Medicaid and PPO commercial plans. In order to fix this,  the patient needs to call and add you as their PCP, and then, you will need to resubmit the claim.

It is best practice anytime you get a new patient to remind your front desk to have the patient add you as their PCP with their insurance provider.

COVID-19 Vaccine (6 months – 5 yrs old) Reimbursement Update

Many practices are still seeing denials; however, we have seen some payments from Aetna. As we said last week, we are certain that these new codes will be loaded any day and should pay regularly. If you continue to have issues, please reach out to us, and we are happy to help resolve these!