Nierman Practice Management Logo
Follow us on Facebook
Follow us on Twitter
Connect with us on Linked In
View demos and More on You Tube
DentalWriter Software Logo 1-800-879-6468
Login   Register Here

Notification

Icon
Error

New Topic Post Reply
Guest
#1 Posted : Thursday, May 23, 2019 11:05:56 AM(UTC)
Quote
Guest

Rank: Guest

Joined: 9/8/2012(UTC)
Posts: 979

Was thanked: 16 time(s) in 15 post(s)
So I attended your course in NY a few weeks ago and I am trying to get our first pre-auth... when I called the insurance company they told me because her policy is an HMO policy and we need to do something else... do you know what we need to do.
courtneydsnow
#2 Posted : Friday, May 24, 2019 9:48:13 AM(UTC)
Quote
courtneydsnow

Rank: Administration

Joined: 11/21/2012(UTC)
Posts: 1,353

Thanks: 39 times
Was thanked: 47 time(s) in 47 post(s)
Hi Guest!

It sounds like the insurer is likely referencing a gap exception request, or out of network exception request. This is a request to the medical insurer to allow the patient to utilize their in-network benefits at your practice as an out of network provider (because typically HMO plan only have in-network benefits available). Typically medical insurers will approve these requests if there is not already another practice within a "reasonable distance" who is in-network who can provide the service. The reasonable distance is typically set between about 30-40 miles - but could be higher or lower depending on your region and the insurer.

If you have the DentalWriter software, there is a sample gap exception request you can use the QuickLetter templates in any patient chart.

Hope this helps!

Quick Reply Show Quick Reply
New Topic Post Reply
Forum Jump  
You can post new topics in this forum.
You can reply to topics in this forum.
You can delete your posts in this forum.
You can edit your posts in this forum.
You cannot create polls in this forum.
You can vote in polls in this forum.