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. Prior Authorization . Health insurance can be complicated—especially when it comes to prior authorization (also referred to as pre-approval, pre- authorization and pre-certification). We've provided the following resources to help you understand Anthem's prior authorization process and obtain >authorization</b> for your patients when it's. Dr Mikhaylova, continued on at North Shore University Hospital to complete a fellowship in clinical neurophysiology with a focus in epilepsy. As per New York Neurology Associates' Office Policy: - We recommend that new patients be prepared to spend 1-2 hours at the office, as testing may be recommended after consultation with the physician. Members and their dentists will need to consult the member's benefits plan to determine if any exclusions or other benefits limitations apply to this service or supply. ... Inpatient or outpatient Revision Dates: Original Policy: January 31, 1999 ... Dental Clinical Policy Bulletins are developed by Aetna to assist in administering plan. This policy addresses reimbursement of inpatient consultations. Policy Statement A consultation is a type of evaluation and management (E/M) service provided by a physician at the request of another physician or other appropriate source. Consultation services are part of a course of action that starts when a physician. The coding depends on the admission status of the patient when seen and whether the patient is classified as Medicare or non-Medicare. For Medicare patients, inpatient consultations are reported with the initial hospital visit codes (99221-99223). Do not append modifier AI, which is only used by the admitting physician. Blue Cross and Blue Shield of Texas (BCBSTX) (the Plan) may use reasonable discretion interpreting and applying this policy to services being delivered in a particular case. BCBSTX has full and final discretionary authority for their interpretation and application to the extent provided under any applicable plan documents. Clinical, payment, coding and policy changes. We regularly augment our clinical, payment and coding policy positions as part of our ongoing policy review processes. In an effort to keep our providers informed, please see the below chart of upcoming new policies. Per our policy, which is based on AMA CPT and HCPCS Level II manuals, the removal.