Have you ever wondered how long a pre-authorisation number is valid?
How many didn’t realise some insurance companies deem pre-auths have a life span?
For example:
I was asked to invoice for a surgical episode from last week.
The patient had the right pre-authorisation reference. The CCSD code was correct too.
However, the pre-auth code was dated January 2021.
This particular PMI decreed the code was only valid for 45 days. Now what?
Pick the phone up
Call the insurance company. Explain why the surgery took place so long after the issue of the pre-auth reference.
It shouldn’t be a problem.
Funnily enough, another MHM client asked us to invoice against a pre-auth of a similar age to the above example. There was no issue in this second example. The insurance company concerned in this case deem pre-auth to be “live” for six months.
But have you considered why there was such a delay between the issue of the pre-auth and the episode?
Might be a perfectly reasonable explanation.
However, if the code was issued 6 months ago and the episode took place last week, questions will be asked.
Some insurance companies will decline if an invoice is submitted for payment six months after the episode.
Life span
Pre-authorisation have a life of their own. Clinic and surgical episodes should be invoiced within seven days at the maximum.
How many of you are NOT meeting this deadline?
pete@medicalhealthcaremanagement.co.uk