Billing Medicare when a Medicare HMO does not pay

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Mansfield Center, CT
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I work for a FQHC and I am having a big problem trying to figure out how to bill Medicare when the Medicare HMO does not pay. I am not sure which Condition codes to use or occurrence codes. I am tried looking and I am stumped. Any help would be appreciated!
 

hperry10

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Hyannis
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The Medicare Advantage plan did not pay? What was the reason? Medicare Advantage replaces Medicare.

Heather
 

CodingKing

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The Medicare Advantage plan did not pay? What was the reason? Medicare Advantage replaces Medicare.

Heather

I wanted to add on to part of my nevermind. I mentioned the same but corrected myself. I did read FQHC can submit to CMS for the difference between MA plans contract rate and CMS rate for FQHC, However i'm not sure if complete denial makes any difference.
 
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