Medical Billing Forum

Billing => Billing => : CIA_2019 August 23, 2019, 03:24:57 AM

: Home Health Billing with Blue Cross
: CIA_2019 August 23, 2019, 03:24:57 AM

Hello all!

Does anyone have any experience billing BCBS for PDN services? How was the process? They are giving a run around because the patient has Medicare which does not cover home health services...

Any feedback / tips will help!

Thanks!

: Re: Home Health Billing with Blue Cross
: Michele August 27, 2019, 04:55:30 PM

Medicare does cover home health services.  Is this something specific that isn't covered?  Maybe you will have to bill Medicare first to get a denial?  Or try the GY modifier if it is truly a non covered Medicare expense.

: Re: Home Health Billing with Blue Cross
: CIA_2019 September 05, 2019, 11:57:42 AM

Hello-

Can you give a little more detail on the GY modifier?

Thanks

: Re: Home Health Billing with Blue Cross
: kristin September 06, 2019, 01:14:07 AM

Google is your friend in this situation. Type "GY Modifier" into Google, and you will get all the information you need.

: Re: Home Health Billing with Blue Cross
: CIA_2019 September 06, 2019, 06:22:46 PM

Awesome! Does the GY modified work if you are not in network with Medicare?

: Re: Home Health Billing with Blue Cross
: Michele September 09, 2019, 08:20:00 PM

There is no "in network" with Medicare.  A provider is either a Medicare provider or not enrolled as a Medicare provider.  If they are not enrolled as a Medicare provider they are not supposed to treat Medicare patients.  A provider can be a Medicare provider who is Non Par.

: Re: Home Health Billing with Blue Cross
: PMRNC September 10, 2019, 07:22:17 PM

Michele is correct..there is no in/out network really. But it's all about accepting assignment with Medicare. Non par providers can still accept assignment, a par provider MUST accept assignment and naturally those who could and have opted out can't bill Medicare at all.