How to Bill for LPC Services When Client has Medicare Primary and BCBS Secondary in Another State

by Lauren Levine
(Bentonville. AR)

Hi. I am an LPC (Licensed Professional Counselor) in Arkansas. I am not eligible to bill Medicare. My client has Medicare part B primary and BCBS secondary. I am trying to figure out how to bill to be reimbursed.


One factor that complicates this further is that her BCBS is out of New Jersey.
I have tried several ways but no luck yet.

Now NJ is saying that I must send some type of letter to state that I am not able to receive reimbursement from medicare.

I'd appreciate some guidance on this. Each time I call BCBS either in AR or in NJ I have to re-explain situation to new rep.

I know there is a way. Just got to find it.

Thanks.


Response:
We haven't encountered this messy a billing situation quite like this but will be glad to post in hopes one of our visitors may be able to help.

I suspect New Jersey BCBS needs documentation showing you are not eligible to bill Medicare. If you have any documentation to support this I would certainly send in hopes this would satisfy them

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Mar 29, 2018
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Medicare primary
by: Cris Caleffi

Hi, try using modifier GY and bill directly to BCBS. Since you can't credential with Medicare, this would probably work. Keep us posted!

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