{"id":1843,"date":"2024-12-06T17:50:26","date_gmt":"2024-12-07T01:50:26","guid":{"rendered":"https:\/\/www.qualityhealth.org\/adminsimp\/?page_id=1843"},"modified":"2024-12-06T17:59:27","modified_gmt":"2024-12-07T01:59:27","slug":"reconsideration-of-a-health-plans-policy-regarding-code-edits-2","status":"publish","type":"page","link":"https:\/\/www.qualityhealth.org\/adminsimp\/reconsideration-of-a-health-plans-policy-regarding-code-edits-2\/","title":{"rendered":"Reconsideration of a Health Plan&#8217;s Policy Regarding Code Edits"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row][vc_column][vc_column_text css=&#8221;&#8221;]Outlines practices to be followed:<\/p>\n<ul>\n<li>by provider organizations when requesting a health plan to reconsider their policy about a specific code edit and<\/li>\n<li>by health plans when processing and responding to those requests. (Note: This BPR is related to policy changes and not specific claims)<\/li>\n<\/ul>\n<p>&nbsp;<br \/>\n<strong>BPR Document<\/strong><br \/>\n<a href=\"http:\/\/www.qualityhealth.org\/adminsimp\/wp-content\/uploads\/sites\/25\/2024\/12\/Reconsideration_Code_edits.pdf\" target=\"_blank\" rel=\"noopener\">Reconsideration Regarding Code Edits BPR<\/a><\/p>\n<div id=\"block-ohp-sub-theme-content\" class=\"block block-system block-system-main-block\">\n<article class=\"node node--type-best-practice-recommendation node--view-mode-full\">\n<div class=\"node__content\">\n<div class=\"field field--name-field-bpr-file field--type-file field--label-above\">\n<div class=\"field__label\">\n<div class=\"field field--name-field-bpr-category field--type-entity-reference field--label-above\">\n<p><strong>BPR Category<\/strong><br \/>\nClaims Edits<\/p>\n<\/div>\n<div class=\"field field--name-field-legislation-page field--type-entity-reference field--label-above\">\n<p class=\"field__label\"><strong>Legislation Page<\/strong><br \/>\n<a href=\"https:\/\/www.qualityhealth.org\/adminsimp\/essb-5346\/\">ESSB 5346<\/a><\/p>\n<p><strong>Legislative Section<\/strong><br \/>\nSection 9 (1)(e)<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/article>\n<\/div>\n<p>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"[vc_row][vc_column][vc_column_text css=&#8221;&#8221;]Outlines practices to be followed: by provider organizations when requesting a health plan to reconsider their policy about a specific code edit and by health plans when processing and responding to those requests. (Note: This BPR is related to policy changes and not specific claims) &nbsp; BPR Document Reconsideration Regarding Code Edits BPR BPR&#8230;","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"class_list":["post-1843","page","type-page","status-publish","hentry"],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.qualityhealth.org\/adminsimp\/wp-json\/wp\/v2\/pages\/1843","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.qualityhealth.org\/adminsimp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.qualityhealth.org\/adminsimp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.qualityhealth.org\/adminsimp\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.qualityhealth.org\/adminsimp\/wp-json\/wp\/v2\/comments?post=1843"}],"version-history":[{"count":3,"href":"https:\/\/www.qualityhealth.org\/adminsimp\/wp-json\/wp\/v2\/pages\/1843\/revisions"}],"predecessor-version":[{"id":1847,"href":"https:\/\/www.qualityhealth.org\/adminsimp\/wp-json\/wp\/v2\/pages\/1843\/revisions\/1847"}],"wp:attachment":[{"href":"https:\/\/www.qualityhealth.org\/adminsimp\/wp-json\/wp\/v2\/media?parent=1843"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}