Wiki FQHC Billing

[RobinCreighton2023]

Hi all: Quick question, if you receive encounter rate billing (as we are an FQHC) for a face-to-face visit that includes your provider giving a FOBT (fecal occult blood test) which the patient is to return, once they do this, do you then bill Medicaid/Medicare and/or private insurance company for the test and/or results from that card without another face-to-face encounter? It seems like double-dipping to me but we are not sure. I hope this makes sense. Thanks for any help the group can give me.

Robin Creighton, CPC-A

 

[fhcso2014]

Carrie Howser CPC

Anytime you have a face to face encounter with the Physician, you are to add a Gcode and bill for that encounter. Even if it is for an encounter that is to discuss lab results.

 

[arrana]

Hi Robin,

Not sure I entirely understand your question. When the patient returns the FOBT card, if they see a provider and documentation and medical necessity warrant an office visit, then yes, you would bill it. If the patient just drops the FOBT off without seeing the provider then there is nothing to bill. Does that help?

Arrana

 

[rcj0401]

If I understand what you are asking, we bill the test when the card is given out. It is the patients responsibility to return it. If they do not and call later we will certainly then proceed with removing charges but otherwise if the card leaves the patient is billed.