Rank: Guest
Joined: 9/8/2012(UTC)
Posts: 54,136
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We have called for preauth and they have told us that yes they have out of network benefits, out of network benefits need a referral (which we have), they state that they will not cover 99212 or a 70355because I am a dentist. Can they say that? also can I bill with my DME npi instead to get coverage?
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Rank: Advanced Member
Joined: 7/22/2014(UTC)
Posts: 92
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Hi Guest,
If you are treating the patient for sleep apnea then you will want to let the insurer know you are a DME provider. Being a dentist should play no part in insurance refusing reimbursement for routine services.
Hope this helps!
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