Wiki Naturopath and Billing Secondary Payers

[SienTC1720]

Our office does billing for a naturopath, and he happens to see a few Medicare patients. They all have secondary coverage, mainly VT BCBS. Our problem is in billing them. What is the correct procedure for these patients? The codes he is billing are NOT non-covered CODES, its all E/M visits. The problem is that Medicare just does NOT recognize Naturopaths. This leaves us not knowing exactly what to do.

Our billing system won't let us override and just bill to the secondary without payments/adjustments from the previous payers. I am fearing taking the Medicare out of our system all together, as I'm not sure if we really should be adding a GY modifier, since they are actually covered services.

It's a problem that keeps getting more and more confusing! I'm hoping some of you have come across this situation and have some idea of what to do, where to bill, or who to call and find out the answer! If it helps any, we are in Vermont.

Thanks in advance!

 

[michellepilcher]

I had this yesterday, actually.
I spoke with a Medicare rep that stated we would have to use a 1490s form for each encounter. It has to be filled out and signed by the patient each time then sent with the 1500 form so that they will process for a denial.
Without the form, I was told MCR will just toss the claims out. You can then use your denial for your secondary.


Hope this helps!

 

[SienTC1720]

Yes, that helped so much, thank you!