Claim No. 140119110700, with an underpayment amount owed of $15,845.80.
By having asserted the purported lack of authorization as a basis for denying the hospital’s appeals, SelectCare has waived or is estopped from now relying on the timeliness of the hospital’s appeals as a basis for its denials.
Patient M.C., Claims No. 130096505500, with an underpayment amount owed of $7,860.41; patient M.W., Claim No. 130334646201, with an underpayment amount owed of $6,179.83.
With respect to patient M.C., the hospital included with its appeals an expert report directly supporting the level of care billed (see report from Cherry Abary, D.O. included with Bayshore Medical Center’s second level appeal).
By having asserted the purported lack of authorization as a basis for denying the hospital’s appeals, SelectCare has waived or is estopped from now relying on the timeliness of the hospital’s appeals as a basis for its denials.
Patient M.C., Claims No. 130096505500, with an underpayment amount owed of $7,860.41; patient M.W., Claim No. 130334646201, with an underpayment amount owed of $6,179.83.
With respect to patient M.C., the hospital included with its appeals an expert report directly supporting the level of care billed (see report from Cherry Abary, D.O. included with Bayshore Medical Center’s second level appeal).