Has anyone else experienced consistent denials with Aetna for med mgt codes: ie 99213, 99214, & 99215 for various reasons including no authorization, no referral or provider type cannot bill this procedure? Every time we call to see exactly why it denied, we get different answers. I've spend 1 hour today, trying to get to the bottom of it and I still don't know if I'm clear with what we need. Some reps say the plan needs a PCP referral, another rep says we need pre-auth, pre-cert dept says it's not needed for mental health, some say add modifier 25, etc... help!
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