Suli Argumentative Essay
I spoke with Suli. From my understanding that claims should be processed with LAUSD provider and pay-to. But since they are submitting HCFA (CMS1500) form it might have caused some confusion in the Claims or PNO departments, since those claims are being processed with a non-contracted individual provider resulting in claims denials or forwarding to the PPG.
Creating a fake PPG won’t solve the issue here since we are still having claims processed with individual providers. I will wait until Suli sends me the claims report to have a deeper look into the claims. Given the urgency of this situation, I will get back to you as soon as possible with my findings and a suggested
Creating a fake PPG won’t solve the issue here since we are still having claims processed with individual providers. I will wait until Suli sends me the claims report to have a deeper look into the claims. Given the urgency of this situation, I will get back to you as soon as possible with my findings and a suggested