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Wiki FQHC advantage plans

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thopper

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Paoli, IN
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When billing advantages plans as a FQHC do you split the claims?
 
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It depends on the advantage plan. I work at an FQHC, and we have to split the claims for Humana, Wellcare and UHC Dual Complete. Basically anything that gets billed on a UB, gets split. there are a few Medicare advantage plans that for some reason go on HCFA's, and those don't split. For the ones that do split, we put the E/M and G code on the UB, under POS 50, and the labs/radiology gon on the HCFA, under POS 11. Hope that helps!
 
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