Recent Posts

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Patient Billing / Re: Medicare Billing | Rendering Provider
« Last post by Michele on Today at 02:13:22 PM »
No you need to complete a CMS 855R form to re-assign benefits to the group.  It's a simple form and is available online at:
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/cms855r.pdf 
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General Questions / Creating a Credentialing Policy
« Last post by Jmojica on Today at 02:12:07 PM »
Hello All! Happy Tuesday! I need to create a credentialing policy and could really use some guidance to get the ball rolling. Any advise or guidance?
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Billing / Re: New York Work Comp
« Last post by Michele on Today at 02:11:36 PM »
I have not billed for WC in VA, but I do bill for WC in NY.  NY has WC4 forms that can be used for billing, however if you are attaching office notes you can use the CMS 1500 form.  The WC4 and WC4.2 must be used if office notes are not being sent.  A copy of whatever you send must also be sent to the state WC Board as well.  Feel free to post any additional questions.
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Facility Billing / Re: Medicare Billing Question
« Last post by Michele on Today at 02:09:07 PM »
Just to add to this, the PT has to be credentialed, as Kristin stated, but also linked to your group using the CMS 855R.
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Patient Billing / Medicare Billing | Rendering Provider
« Last post by avehildebrand on Today at 11:58:07 AM »
Hello,

Our claims were being denied due to our rendering provider not being contracted. I looked into it and she has a Medicare ID and is contracted. I added her to our CMS system as a staff and user under our account. Will this fix the issue? Do I need to re bill all of the Medicare claims that were denied?

Any comments or feedback would be much appreciated.

Thank you!

Ave
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Facility Billing / Re: Medicare Billing Question
« Last post by avehildebrand on Today at 09:18:34 AM »
Thank you Kristen!  :)
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Facility Billing / Re: Medicare Billing Question
« Last post by kristin on June 15, 2018, 02:18:55 PM »
Yes, the PT has to be credentialed with Medicare, since she is the rendering provider.
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General Questions / Re: 200+ Splinter & Thorn Removal Podiatry
« Last post by kristin on June 15, 2018, 02:17:14 PM »
51 modifiers are added by insurance companies when they process claims, so I wouldn't use that. If you are indicating that each FB removal is in a different site/area, you would use 59 or one of the X modifiers. Be aware that depending on the insurance, you could run into a MUE edit where they only allow so many units of 10120 to be billed on one DOS. In which case you would have to appeal with notes.
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Billing / New York Work Comp
« Last post by stellerdobes on June 15, 2018, 12:15:26 PM »
I am in VA and bill for a primary care here in VA so I am use to billing work comp.  My question is how different is billing work comp in New York? 

I have been offered a job with a clinic in New York to do their wc billing only.  Would anyone be willing to let me pick your brain on the difference?

With the wc in VA we print it on a hcfa 1500 send office note to insurance and thats it.  If Im not mistaking with NY don't you have to send something to the state also?  IS this a difficult process?  They have about 20-30 wc pts a week.

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General Questions / 200+ Splinter & Thorn Removal Podiatry
« Last post by EDREIBELBIS on June 15, 2018, 08:16:06 AM »
Hello all!

My Doc just pulled me back to discuss a case we have coming in today, patient was seen yesterday and it was found that he has roughly 200+ splinters/thorns in his feet. He is coming back in today for a complete forgien body removal.

Can I bill these individually for each removal? These are subcutaneous and not into the muscle so I feel that the 10120 will be the proper code to use. However, I'm no clear on billing for multiple removals. What I have found suggests that I should bill the first removal and then all subsequent w/ a 51 mod. i.e. 10120, 10120 (x10) 51

Any guidance would be helpful, it is anticipated that this will be a very long process and we want to make sure we can get reimbursed for the work.

Thanks in advance for your help!

Emily
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