Not a missing precert. Auth AUT-40711 was obtained 14 Mar and is in the chart. It was filed against the ordering provider's NPI, not the rendering facility's, so their system never attached it.
Letter drafted, policy section 4.2 cited, authorisation attached. Appeal, not correct-and-resubmit.
CO-298801-072 DAYS
Office visit, established · 99214
STATEWIDE HMO · BILLED $186.00
Timely filing is wrong. The clearinghouse acknowledgement shows receipt on 02 Feb, inside the 90-day window. That acknowledgement is the entire appeal.
Correct and resubmit, not appeal
CO-978798-4121 DAYS
Injection, tendon sheath · 20550
REGIONAL PPO · BILLED $312.00
Modifier 59 was on the original submission but is absent from the 837 the payer received. This is a transmission issue, appealing would lose. Rebill with the modifier.