MEDI-MEDI BILLING

[msskenny]

We are an OPMH clinic and accept Medi-Caid. We do not accept Medicare. Our clinic is not a participating provider with Medicare.
When a patient has been seen under their Medi-Caid and Medicare just became effective (now Medi-Medi) how do we send a claim to Medicare even for a denial if we are not enrolled with Medicare to bill electronically? We are considered a large provider, will Medicare accept a paper claim by mail?
How can we keep this patient if we don't accept Medicare only Medi-Caid?

Thank you,

msskenny

[Michele]

If you are a non participating Medicare provider then you will need to submit the claim to Medicare.  Medicare most likely will require you to get set up to submit electronically.  It really depends on the amount of claims you are submitting.  They usually will let you submit for a time, but then they will send you a letter giving you 30 days to comply. 

Michele

[Gloriamaxx]

How do you become registered to bill for Medicare and Medicaid?  I am new and getting all research papers together before I launch in Spring 2010?  I hope to have 1 or 2 doctors....but I need help in trying to start. 

[Steve Verno CMBS, CEMCS]

Here is a link to par vs nonpar with Medicare

http://www.acatoday.org/content_css.cfm?CID=3138

[msskenny]

You said if we are a Non Participating Medicare Provider... ?  What is the difference between Non Participating and a clinic that is not enrolled/credentialed/ or even approved to bill Medicare? We don't have a Medicare number or anything. It is just simply an insurance we don't deal with.....?

Thank you,

msskenny

[Michele]

Non participating means that you are a Medicare provider but you do not not accept Medicare's assignment (or allowance).  A non participating Medicare provider has a PTAN (provider transaction number) which is required to bill Medicare. 

Michele