Posted in Insurance, MU Stage 2 and 3, My services, Training

Checking the Spelling of Medications, especially when completing a prior authorization.

Recently, I had a situation in an office of an allergy/immunologist – regarding a denial of the medication (that requires prior authorization),  because of a failure to double check the spelling of medications; during a verbal prior authorization request. Please note that both medications did sound the same, however were two completely different medications. In thi situation, neither the prior authorization rep or the office manager asked for a spelling of the medication. Result: denial of the medication.

Remember medications requiring prior auth need to meet the medical policy standards (medical necessity), for that specific medication or you will receive a denial.

This is why I love to do an online authorization request instead. Once you fill out all the needed clinical questions and upload the needed medical notes, there is no confusion regarding which medications the patient is taking and how they are spelled or pronounced.

Investing in a scanner, for your office, is a great idea! 

Now its your turn: have you used online prior authorization tool? Does your office have a scanner to scan documents?

Author:

My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s