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| 6/6/2021 @ 2:55:00 PM
Post 1 of 4
Contributor: Cindy Bates, Three Rivers Medical Clinic, LLC
Hi All, Medicare and now Humana are rejecting our lab codes--CBC with diff, CMP, lipid, etc, etc, etc. My biller tells me that my RHC "does not have a high enough CLIA level" and that is why they are being rejected. However, we send out these labs to be run by a reference lab so that shouldn't be an issue. I called our state CLIA office and confirmed that it is not our CLIA level that is the issue. Thoughts? Cindy Bates, FNP-BC Three Rivers Clinic, Three Forks MT 6/6/2021 @ 4:07:00 PM
Post 2 of 4
Contributor: Joann Timm, Jefferson County Health Center RHC
Good afternoon
I do believe there are a few different things with the CLIA issue-one is are you entering your CLIA number on your claim for identification? It does depend on what kind of RHC you are-independent or hospital based- and then I also believe there have been quite a few changes over the last couple of months that involve CLIA not necessarily those CPTs but others, and we certainly know in our industry when there is a change to something it affects many other things. I do not have any answers but will be checking with my team to see if they are seeing these things. Here is one of the changes that involve CLIA-not anything new particularly but went into effect recently https://www.cms.gov/files/document/r10831cp.pdf 6/6/2021 @ 7:20:00 PM
Post 3 of 4
Contributor: Mindy Pownell, Avera Medical Group - Sioux Falls
For Medicare and Humana, the performing lab needs to bill, not your clinic.
Mindy Pownell, CPC, CFPC | Director, Clinic Coding Avera Health 1325 S Cliff Ave | Sioux Falls, SD 57105 Work: 605-322-7917 Cell: 605-212-3480 www.Avera.org On Jun 6, 2021, at 1:55 PM, NARHC News  EXTERNAL EMAIL. Proceed with caution. If you suspect phishing use the Report Phishing button or forward this email to phish@avera.org 8/27/2021 @ 12:41:00 PM
Post 4 of 4
Contributor: Jeana Murphy, CCMH Medical Mall Clinic
If your clinic is provider based, the clinic cannot bill CLIA waived lab tests done in the the clinic to Medicare. Your parent company (i.e.) Hospital has to bill these.
Jeana Murphy CCMH Medical Mall Clinic RHC Biller in Missouri |
