What if a test was done prior to the authorization approval date?

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The claim will deny.

Example: A facility or provider office initiates an authorization on March 1, 2009.  The patient has the test done on March 1st, but eviCore does not approve the test until March 2, 2009.  The approval date range is from March 2 – June 2, 2009 (90 days).  Because the date of service is not within the approval range the claim will deny.  It is strongly recommended that patients do not have tests done until eviCore has issued a determination. 

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