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Looking for best practice for billing Medicare for a Naturopathic provider in an FQHC

  1. #1
    Default Looking for best practice for billing Medicare for a Naturopathic provider in an FQHC
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    Looking for best practice for billing Medicare for a Naturopathic provider in an FQHC setting. We have a large Medicare population in our FQHC wanting to see our Naturopathic Physician. We have informed them that Medicare does not currently cover services provided by a Naturopathic Physicians and they are requesting we bill Medicare anyway. The patients are given an ABN to complete.
    What is the best way to bill this to let Medicare know that we know services are not covered but the patient is requesting it be billed for proof of denial. Is there a modifier we should be using? I know there is a modifier for excluded services but the service would be covered if provider by a different provider. I have never worked with or billed for a Naturopathic provider so any help would be appreciated.

  2. #2
    Location
    Harrisburg Pennsylvania Chapter
    Posts
    45

  3. Default Interested as well
    We just recently employed a Naturaopathic doc at our FQHC. If you'd like to brainstorm together, please let me know!

    Thanks!

    Yvette

  4. #4
    Default
    Medical Billing
    Yvette,
    you can send me a PM if you would like.
    What I have learned so far is that when billing Medicare for part B services not included in the FQHC PPS codes the charges will deny due to no provider enrollment.
    When billing PPS codes to part A the claims are processed under Tax ID and get paid. Still waiting to hear back from the MAC to determine if this is correct as Medicare does not recognize / enroll Naturopathic providers

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