Aetna has followed the industry in an attempt to reduce benefits paid.
A letter dated December 2007 was mailed out to many of our hospitals and providers, a copy is attached.
We noticed a very similar policy BCBS established in 2007 except without the 23 modifier override for endoscopies.
We continue to suggest the following guidelines, in attempt to afford any and all opportunity to secure payment for services rendered.
- Complete the Advanced Beneficiary Notice for patient’s outside the guidelines. We are attaching another copy for your files.
- Work with your surgeons to properly document the reason for your services.
- Make arrangements for the facility to forward copies of operative reports, H & Ps, and any other supporting documentation.
None of this will guarantee payment for your services.
Of course, should you have any questions, please call our office.
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The information included in this publication is provided, among other things, to alert you to legal developments and should not be considered legal advice. Specific questions about how this information affects your particular situation should be addressed to your attorney.
Editor: Philip Blann (pblann@anesthesiabilling.com).
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