You should contact the payer and ask for the reason(s) that the claim was denied and what information is necessary to correct the claim (make sure you document the conversation). In addition to reviewing on a claim by claim basis, review denials for trends for certain submissions. Talk with your utilization review team to get a sense as to what is impacting covered vs. non-covered claims, identify trends, and seek to proactively reduce and correct common mistakes.

For additional questions or comments, please e-mail the UBO Help Desk, or leave a message for the Help Desk staff at 202-776-1532.

Yes, MTFs can bill for acupuncture and chiropractic services, provided there are UBO approved rates for the services (CPT or HCPCS codes). However, the payer may not cover acupuncture and chiropractic services if the payer determines those services are not covered, unless they are deemed medically appropriate by the provider.