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Original Comment We have a patient that Anthem Siemens group plan code that had HDR skin. Anthem Siemens group was called benefits were verified and we did ask if the HDR skin will be covered an ask if it needed and authorization Anthem stated no authorization needed for HDR Skin and it was a covered benefit, that the only thing that would need authorization was IMRT or Proton. <br /> <br /> <br /> <br /> Now patient has completed their treatment Anthem Siemens group was billed and claim was returned/rejected stating not a covered benefit and codes are investigable/experimental treatment code.<br /> <br /> <br /> <br /> This patients insurance should be paying for this not the patient, it was verified benefits with all questions ask to make sure it was covered. HOW CAN THIS BE RESOLVED. Dr has already did a peer to peer review to get this resolved but Anthem refuses to pay.

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