On 07/04/22 my husband went to Hoover Grove AFC for a dog bite. The care needed was minimal, consisting primarily of evaluation and a tetanus booster. Because it was received as a treatment (vs routine vaccine) and in a clinic setting (vs a pharmacy), the booster ($50) is covered under Medicare Part B. We have been arguing for months that this is covered and we should not continue to be billed. Your response (when we could finally get one), "We are not credentialed to file for that." Wait, what? You can administer the treatment but cannot file with Medicare for reimbursement? Over the months, we have made every effort to contact AFC to discuss this via phone calls (endless wait times; once got connected only to have the "customer service" rep hang up b/c I continued to ask how we could get this resolved and she kept simply repeating the "not credentialed to file" nonsense) and multiple emails, including documentation from Medicare's own website on how this needed to be filed. No progress. We communicated with Medicare. Apparently, this is something that needs to be submitted by the provider – i.e. you. We finally paid the $50 (the outcome you likely expected based on your customer service strategy of stonewalling). If the “not credentialed to file for that” is a real thing, perhaps you should consider only offering care for which you can request insurance reimbursement rather than creating a situation for patients to wade through later?
Desired outcome: File all parts of the 07/04/22 claim with insurance, in this case Medicare B, an expectation that any fully insured patient would have of any legitimate provider.