Anyone with Blue Shield of CA?
Hi, I was wondering if anyone with Blue Shield of California is having issues with their claims getting paid since the code change to J0013? It is being initially denied by Blue Shield and is being re-routed to my medical group to deny so it can finally be sent to them and that it was the system doing it. I was told it was a glitch and the notes they wrote would prevent issues in the future, but nothing changed. After speaking to many reps, I was told I had to call to have each one manually adjusted for the spravato charge and it was working until last week when I talked to several that seemed inexperienced reps that I had to explain over and over that I have my authorization, its not a nasal congestion spray, and is being sent elsewhere on accident since Blue Shield is responsible for mental health services. Then they finally say they will adjust it but it never goes through. I ask for a supervisor, I can't get a call back. I ask for previous reps that have helped me, they are not available. Last I was told they would be re-processed but I am unable to follow along on the website, they said it can take 30-45 days. Has anyone else had this problem? Does anyone know of a solution?