Name of Manual - Blue Cross and Blue Shield of Minnesota

Claims Filing
Rural Health Clinics and Federally Qualified Health
Centers
Billing for Medicare
Primary
Billing Other Than
Medicare Primary
Rural Health Clinics (RHC) and Federally Qualified Health
Centers (FQHC) are Medicare provider designations. Medicare
requires RHCs and FQHCs to bill services in an institutional
format (837I).
Since billing as a RHC or FQHC would be secondary to Medicare,
we will only accept these clinic claims on the 837I.
The claim should be submitted following Medicare billing
requirements (e.g., TOB 071X and revenue code 0521 for a clinic
visit to a RHC).
If Medicare is not primary, services must be billed to us as a clinic,
not as a RHC/FQHC, under your Blue Cross clinic provider
number or NPI and submitted as a professional claim 837P.
8-38 Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (05/10/12)