This article is for managers of intake, utilization review, and case management at acute care hospitals. Please share this article with your front office and billing staff.
You can avoid claim denials or post-payment recoveries for NICU level of care services by billing Blue Cross at the NICU level you were authorized for. The level approved should match the level on the claim submitted.
You can determine the level approved by reviewing the authorization approval you received from ProgenyHealth. The authorization levels for NICU level of care for premature and medically complex infants include levels 1, 2, 3, and 4.
To read more about this program, which we offer to our members at no additional cost, log in and go to News. Scroll down to the News Alert dated May 4, 2023: "ProgenyHealth will support premature and medically complex infants."
You can learn more about how ProgenyHealth will work with you on this process by watching a recording of our recent webinar.
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