Author Topic: Medicare reassignment  (Read 914 times)

ERBurley

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Medicare reassignment
« on: August 21, 2018, 12:58:58 PM »
I was assigned a client, Psychologist, who currently bills medicare under a group.  He is conducting a program at another facility completely separate from the group with which he is "employed".

I attempted to bill for him as an individual since I was given his PTAN and NPI and I used his SSN as TAX ID.  This was rejected.  After researching & speaking to reps I had him fill out an 855R which has been "in process" for an entire year!  First with Cahaba then it was transferred to Palmetto GBA more recently. 

I have never in my 23 years of billing been faced with such a problem.  I cannot get a straight or consistent answer from Medicare regarding the correct way to bill for him. 
Will filling out the 855R affect his employer billing his current work?
Will the current 855R actually be the answer to his being able to bill as an individual?

Thank you!!

Elizabeth Burley
Augusta Medical Billing

Michele

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Re: Medicare reassignment
« Reply #1 on: August 22, 2018, 12:50:23 PM »
If he is set up with Medicare as just an employee of a group, then he is not set up to bill individually.  You must complete the CMS 855I to indicate that he will also be billing individually under his SSN and individual NPI (in addition to the group he is employed by).  Section 4B allows him to indicate that he works for a group, and section 4C will allow him to set up his individual practice.  He must also complete a CMS 588 EFT and CMS 460.
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ERBurley

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Re: Medicare reassignment
« Reply #2 on: August 24, 2018, 11:49:54 AM »
Thank you so much!  I appreciate your prompt and accurate response. I have completed these & will hope for the best...

Medical Billing Forum

Re: Medicare reassignment
« Reply #2 on: August 24, 2018, 11:49:54 AM »