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I have been trying to bill some of our clients who are needing vaccines. Menactra code 90734 sl. Came back as service is not covered under members benefit plan. When I called the office they said the client has benefits so we resubmitted the claim. Now it comes back as payment not appropriate for services. So I called again today, the gal told me it was my code I was using but was unable to give me any guidance. What has everyone been using?
Be sure you are using the SL only on people under the age of 19, because VFC is only for people under 19. This is the correct CPT code under diagnosis code Z23. I’ve had troubles with HB, but this isn’t one of them! Good luck.
I have had problems with Healthy Blue paying for immunizations and other claims for me too and couldn’t get anywhere by calling Healthy Blue. I called my Provider Rep and she found out what the problem was and told me how to fix it.
I recently submitted several hundred dollars worth of claims and only paid for 1 Menactra and 1 Hep A. I guess I will be making some calls!!
Stacey, would you share with us how you fixed the Menactra and Tdap issue?? Apparently they can’t figure out who my Rep is to contact.
I submitted a bunch of claims Tdap, Menactra and Pentacil were not paid saying not a covered service. I appealed it and they still won’t pay.
Thanks
MeganI contacted my Provider Rep who found out that Healthy Blue set us up as something other than a Health Department and they had to fix that along with fixing the agreement we had with them (All of this was Healthy Blue’s mistake). WE had to resubmit all the claims once they got all the paperwork completed appropriately which was irritating because it was their mistake and all of our claims were denied. They could easily have gone back to every one of our claims and fixed their mistake but I had to resubmit each one as a replacement claim even though I didn’t make any changes to it.
For anyone interested. I just spoke with a PR from Healthy Blue Missouri. It is an issue with their system that immunizations are being rejected. They are in the process of figuring out the issue and once they do, all claims that had been denied will re-run through and get paid.
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