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6 Eyecare Billing Rejections you can overcome Medical billing rejections and denials are often used interchangeably - however, there is a distinct difference. A rejected medical claim fails to meet specific formatting, billing criteria, and data requirements. Because a rejected claim has never been processed by a clearinghouse, insurance payer, or the Centers for Medicare & Medicaid Services (CMS), the claim is not considered "received," and it did not make it through the adjudication system. The reasons behind the Eyecare Billing rejections have been listed down below: 1. Mission or invalid information 2. Same-Day or Duplicate 3. Code or Modifier Missing or Invalid 4. Patient not Eligible 5. Missing or Invalid Billing Provider ID 6. Provider not Credentialed by Payer Are you also facing these issues in your Ophthalmology Practice? Contact us : info@medmaxtechnologies.com / 888-402-2631.

Understand the difference between Referral and Prior Authorization Referrals are orders from a primary care provider (PCP) to see a specialist or receive certain services from another provider. Prior authorization is approval from the health plan before any patient receives a service or fills a prescription. To know more about eligibility and prior authorization services, contact us at info@medmaxtechnologies.com / 888-402-2631.