Billing for CLIA waived Labs

  1. Hello all,

    How many of your agencies are billing for administration of CLIA Waived Labs? This reimbursement is separate from your episodic payments. It's for documentation and communication of results-not physically drawing the sample. Would love feedback.
  2. Visit homehealthguru profile page

    About homehealthguru

    Joined: Mar '09; Posts: 7; Likes: 3


  3. by   alekpilgrim
    Dear homehealthguru,
    I can not find any info on billing for CLIA waived Labs.
    Do we need to have part B Medicare provider #? Any info would help! Thanks!
  4. by   homehealthguru
    This is one of the those regs that is buried deep into the manuals. Check out the Home Health Online Billing Manual Ch. 10 Sect. 90 D. Classifies HH as a "provider" of lab services, and thus can bill for these services. A Part B # is required, but this is a slightly different process than you would normally go through. If you message me personally, I will give you some more details on the process.
  5. by   alekpilgrim
    I'd be happy to send you a personal message, but can not find a way to do it. I just registered yesterday and perhaps don't have access to this feature yet..
    can I give you my personal email?
  6. by   homehealthguru
    Feel free to pm me for my personal email. Looking forward to hearing from you.
    Last edit by jnette on Oct 14, '09
  7. by   tcoleman5578
    Hi homehealthguru,

    I would like to know more info regarding how to bill for CLIA labs. Please let me know... need your help!

  8. by   homehealthguru

    I would be glad to help you start receiving this reimbursement. With all the changes coming up in 2010, you need to capture every penny available to keep up with the pace. First of all, this reimbursement is a Part B reimbursement. Therefore, the patient must have Part B coverage. Also this is not billed to your RHHI. This reimbursement is handled by your Carrier with claims jurisdiction.

    The process is fairly simple to get set up, but there are several things that must take place in order for you to qualify. There are also a few specific differences from carrier to carrier about which labs (or more specifically, which diagnosis codes) are reimbursable. I would love to help you get set up, but would prefer to discuss the specifics in a private manner. Please Personal Message me your email or phone contact info and I will be glad to discuss further.

  9. by   tcoleman5578
    How can I send a private message?
  10. by   homehealthguru
    personal email address deleted.
    Last edit by jnette on Nov 16, '09 : Reason: TOS.. personal email
  11. by   tcoleman5578
    PM sent!

  12. by   NRSKarenRN
    See icons next to members names:

    to send PM---must have made 15 quality posts in order to RECEIVE PM back.

    to send email to those who permit such contact.

    Please use these mechanisms due to internet safety to prevent webcrawling software from stealing your email address and selling to spammers.

    Thanks for your understanding.
    Last edit by NRSKarenRN on Nov 18, '09
  13. by   RNRutRO
    What is CLIA? I'm sorry, I don't know the "lingo"
  14. by   NRSKarenRN
    Quote from rnrutro
    what is clia? i'm sorry, i don't know the "lingo"
    clinical laboratory improvement amendments (clia)
    the objective of the clia program is to ensure quality laboratory testing. although all clinical laboratories must be properly certified to receive medicare or medicaid payments.
    waived tests are defined to:

    • employ methodologies that are so simple and accurate as to render the likelihood of erroneous
    • pose no reasonable risk of harm to the patient if the test is performed incorrectly;
    • are cleared by the food and drug administration for home use.

    waived tests include dipstick and tablet testing, glucose testing, protime machine use, hemocult etc
    see fda: clia waivers