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Is anyone having a problem with BCN automatically down coding and reducing payments for 99214 and 204's stating they are not supported? They haven't reviewed any medical records, the payment is reduced on the first adjudication.
Cbo014
Is the first dx code a Z dx code or unspecific dx code? Or has the patient seen more than 1 provider for same issue in short amount of time?
I hope I helped
Lady T
It's just another stall payment practice by insurance companies. They either deny by down coding hope you don't have the time and staff to appeal or they do a prepayment review where you have to send records before they will pay any level 4. Its time consuming for all providers and it's a win for the insurance company, they get to hang on to their money a little longer or in some cases not pay at all. Have you seen any insurance company that is not showing a profit?