We are seeing a couple of reimbursement issues across multiple practices and wanted to make sure you are aware (see below):
COVID vaccine codes for 6 months-5-years old – Our first batches sent across multiple practices have come back denied from multiple insurance companies. This is common when new CPT codes are approved, as it takes the insurances time to load the new codes into their system. If you have newer claims, we suggest waiting a week or so to submit your new claims because of the denial time clock. Once denied, you only have 30 days before it will deny for timely response. Holding off on sending new claims for a short time will be less work in the long run while giving the payers time to get everything loaded.
Please see the appropriate CPT code combination in chart to the right.
BCBS – Another issue across multiple practices is that BCBS’s system deletes received claims, and they state they cannot find them, or get them back. If you have received a letter saying a claim can’t be paid for an unspecified reason, or if you have received denials due to an NPI not being on file, you need to reach out to BCBS ASAP. If this is affecting you, make sure when you resubmit, you submit as a new claim because their system does not have a record, and will also deny if not submitted as new. Again, you will need to verify this is the issue with BCBS, and then track all claims effected to resubmit as new.
