Pre-Authorization Changes for 2016

Posted by on Dec 1, 2015 in Practice Information

Pre-Authorization Changes for 2016

Pre-Authorization Changes for 2016

Pre-Authorization Required for Aetna & Coventry Patients beginning January 1, 2016

For all patients with Aetna and Coventry healthcare plans – we have been informed by the insurance companies that a pre-authorization for any appointments dealing with “Pain Management” and/or the back or knees.

But I have headaches you say? Well, given the nature of Osteopathic treatments, Dr. Sneed could possibly end up treating your back to fix your headaches – a detail that is difficult to know ahead of the appointment. Or the insurance companies may choose to include it as a type of pain management.

After speaking with our billing office as well as with various reps at Aetna and Coventry, we have come to the conclusion that it would be in the best interest of our patients to get pre-authorization for all appointments to be billed to Aetna or Coventry insurance programs, regardless of the reason you are coming in to see Dr. Sneed. This is way we can ensure that your visit will be covered per the specifics of your individual insurance plan, and you should not be left with an unexpected bill.

What does this mean for you? If you will be covered by Aetna or Coventry beginning on January 1, 2016 please call us at least 3 business days before you would like to be seen in the office & request that we call in for the pre-authorization (our system does not have a way to alert us to your insurance status). This should give us time to call your insurance company, request the pre-authorization for your visit, speak with the insurance company’s nurse and explain what Osteopathic Manipulation is and why the pre-authorization may be needed, and, hopefully, receive written confirmation of a pre-authorization before you walk through the door.

While we can promise to make every feasible attempt to get a pre-authorization, please be aware that we are not in control of the decisions ultimately made by Aetna and Coventry companies and cannot guarantee a pre-authorization request will be approved.

So, come January please give us a little time to jump through the hoops on your behalf – we’ll do our best to ensure that you can continue to receive the same wonderful care you’ve already experienced with our staff and Dr. Sneed.