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I have claims that are denying saying the patient isnt eligible but I have a new approved PA for the dates of service, why?

April 26, 2017Approved dates denying eligible PA patient service

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I have claims that are denying saying the patient isnt eligible but I have a new approved PA for the dates of service, why?

1 Answer

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An approved PA does not guarantee payment and MO HealthNet cannot pay for services when a patient is no longer eligible. The approval means the services were deemed to be medically necessary but the patient must be MO HealthNet eligible on the date of service.