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Is anyone having issues getting UHC Community to pay on the admin for 90697 SL? The vaccine itself is free through VFC. We have always billed these to the Managed Care Payers and received payment for the administration of the vaccine. ($8.07 per antigen) We have never had issues until recently, just curious if anyone else is? Thanks
No issues here.
Billing Z23 diagnosis code with procedure code 90697 modifier SL and getting paid $32.26
I hope this helps.
I was having this issue also. I talked to a rep on the phone week before last and it was glitch on their side. They are supposed to be correcting it.
I am still having this issue with UHC, anyone having received an update and are now being reimbursed?
Grundy County also still having issues with UHC and Vaxelis. We were getting paid last year but not this year. One of the reps we talked to said it was a pharmacy code. Anyone have the name of a contact person who can help with this???
I reached out to Julie Pace (julie.a.pace@dss.mo.gov) and the state to notify her that UHC Community is denying these. I also reached out to Margaret Andrews| Provider Relations Advocate Office: (314) 592-5949 Email: Margaret_y-andrews@uhc.com at UHC Community. She is handling the review of our claims that have denied with 90697SL. My last update they said it was still in review. Hope this helps- Maybe if everyone with issues reaches out to these contacts they will speed up their reviews. Good Luck!
UPDATE: I just received a response from Margaret Andrews the UHC Provider Advocate. She said that they received confirmation from the state that 90697SL is a payable code. Once their system is updated the claims will be reprocessed. At least they are moving in the right direction. Still find it odd- this is not a new code and we have never had issues with it until now.
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