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When we are billing Healthy Blue for 90707 and 90716 they are bundling the service and paying for 90710. These are for the VFC Program so we have the SL modifier. The reimbursement is the same I just have never seen them do this before and wasn’t sure if I need to do anything? I have notified them on a few that they did this to and they upheld my dispute. We do not bill 90710 since we provide these vaccines separately. Any advice or insight would be appreciated. Thank you all!
I have not been noticing that happening.
However, on a side note what dollar amount are you all getting paid for 90700 SL and 90707 SL? We were getting $16.05, but now we are getting more.
I have had the same thing happening on our claims at Columbia/Boone County. I also have disputed the claims and the message I’m getting is: “This change better represents the services that were performed.” On my claim, I only submitted a 90707 and they still changed it.
As for the question regarding 90700 and 90707 payments, we bill all VFC vaccines at $20.00, so I’m getting the full $20.00 that I bill for those 2 vaccines. My thought is that since they raised the reimbursement rate to $8.07 per vaccine component, that is why you are getting paid at a higher rate now.
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