Wiki FQHC BILLING

[bstewart]

I work for a FQHC, and up until 2021 we were billing Medicare Secondary claims to part B due to the patient has a commercial insurance. Now our claims are denying stating we need to bill to part A because we are a FQHC. I have not been about to fine anything about this when Medicare is the secondary payor. Can anyone give me any information on this?

 

[RaeToll]

I work for a FQHC, and up until 2021 we were billing Medicare Secondary claims to part B due to the patient has a commercial insurance. Now our claims are denying stating we need to bill to part A because we are a FQHC. I have not been about to fine anything about this when Medicare is the secondary payor. Can anyone give me any information on this?

What services are you billing?

FQHC Billing Guide - JE Part A - Noridian

A billing guide for Federally Qualified Health Centers (FQHC) is provided.

med.noridianmedicare.com

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c16.pdf

 

[bstewart]

I work for a FQHC, and up until 2021 we were billing Medicare Secondary claims to part B due to the patient has a commercial insurance. Now our claims are denying stating we need to bill to part A because we are a FQHC. I have not been about to fine anything about this when Medicare is the secondary payor. Can anyone give me any information on this?

We are billing E/M services but, Medicare is the secondary payment not primary.

 

[bstewart]

What services are you billing?

FQHC Billing Guide - JE Part A - Noridian

A billing guide for Federally Qualified Health Centers (FQHC) is provided.

med.noridianmedicare.com

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c16.pdf

We are billing E/M services but, Medicare is the secondary payment not primary.