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- Feb 19, 2008
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trying to manage scenario being denied payment on RFA, though they have not required prior authorization.
per policy of many carriers, if there is any other pathology present, incidental or not, like nerve root impingement.... they will deny payment of RFA after the fact, despite diagnostic response to MBB.
how are you handling the prospects of RFA denials? are you electing not to do the RFA since you may not get paid, work appeals after the fact, and/or hold patient responsible for what their policy won't cover..
per policy of many carriers, if there is any other pathology present, incidental or not, like nerve root impingement.... they will deny payment of RFA after the fact, despite diagnostic response to MBB.
how are you handling the prospects of RFA denials? are you electing not to do the RFA since you may not get paid, work appeals after the fact, and/or hold patient responsible for what their policy won't cover..