NARHC Forum
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| 4/14/2021 @ 4:00:00 PM
Post 41 of 47
Contributor: Nathan Baugh, National Association of Rural Health Clinics
I understand that MACs are still denying these "conflict add-on claims" with DOS between 7/1/20 and 4/1/21. I can confirm that this was not CMS's intent and we are investigating. 5/17/2021 @ 11:55:00 AM
Post 42 of 47
Contributor: Julie York, Marengo Family Medical Clinic
Has anyone seen success in getting these claims paid, yet. I'm trying to determine if we have any recourse or if we need to expect payment going forward from 4/1/21. Thanks.
Julie York Clinic Billing Supervisor Compass Memorial Healthcare 300 W May St Marengo, IA 52301 Phone: 319-642-8155 Fax: 319-642-8142 jyork@compassmemorial.org 5/20/2021 @ 1:30:00 PM
Post 43 of 47
Contributor: Gail Cameron, Family Medicine Clinic - Onawa
We still continue to get ours denied ;--{
5/20/2021 @ 3:41:00 PM
Post 44 of 47
Contributor: Nathan Baugh, National Association of Rural Health Clinics
Gail, Has anyone been able to get one of these codes paid with a DOS between 7/1/20 and 4/1/21? 5/21/2021 @ 9:08:00 AM
Post 45 of 47
Contributor: Shirley Gamble, Sterling Medical Center
Nathan,
I am located in Kansas and submit claims to WPS. We have had NO SUCCESS in getting our "RHC Modifier HCSPC conflict claim for DOS prior to 4/1/2021 paid. Ex: CPT code 11750 DOS 1/21/2021 Initially rejected for procedure code is inconsistent with the modifier CG. 4/14/2021 adjusted in FISS w/D9-recalculation. 4/22/21 Received information claim still did not reimburse. (this was a communication from our billing company) Additional note from billing company--uon review of the HCPCS file, this code still has a "1" listed which means this HCPCS code is not eligible for the all inclusive rate under RHC. Is this enough information? *Shirley L Gamble, CPC* Clinic Coding Manager Sterling Medical Center 239 N Broadway Sterling, KS 67579 620.278.2123 Ext 567 620.278.2712 Fax 7/21/2021 @ 5:23:00 PM
Post 46 of 47
Contributor: Lisa Amerman, Mile Bluff Medical Center RHCs
Good Afternoon, Has there been any updates on how to handle claims with these services that were denied with DOS prior to 04/01/21? I do see that for claims with DOS after 04/01/21, our MAC, NGS, is paying on the codes that were on the list. I have tried sending a "corrective" claim to NGS for a 03/31/21 DOS to see what they do with it. Thank you, have a great day, stay safe and stay well!! Lisa Amerman Patient Financial Services Supervisor Mile Bluff Medical Center 1050 Division Street Mauston, WI 53948-1931 608-847-9775 608-847-2079 (fax) ---------- Original Comments ---------- Last Post By: Shirley Gamble, Sterling Medical Center Nathan, 8/27/2021 @ 11:24:00 AM
Post 47 of 47
Contributor: Jeana Murphy, CCMH Medical Mall Clinic
Nathan,
Just to confirm, Medicare is only going to reprocess to pay the corrected claims that we file with the D9 condition code and Recalculation in the comments that start with dates of service on 7/1/2020 ?
Nothing before 7/1/2020 date of service? As I have a 2/19/2020 date of service with the cpt 11750. Thanks for your help!
Jeana Murphy RHC Biller CCMH Medical Mall Clinic 1317 S Hwy 32 El Dorado Springs, MO 64744 P- 417-876-3592 F- 417-876-2818 Jeana Murphy RHC Biller CCMH Medical Mall Clinic 1317 S Hwy 32 El Dorado Springs, MO 64744 P- 417-876-3592 F- 417-876-2818
---------- Original Comments ---------- Last Post By: Nathan Baugh, National Association of Rural Health Clinics I understand that MACs are still denying these "conflict add-on claims" with DOS between 7/1/20 and 4/1/21. I can confirm that this was not CMS's intent and we are investigating. |
