Author Topic: In-home Hemodialysis Billing  (Read 5457 times)

jpositos

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In-home Hemodialysis Billing
« on: August 17, 2015, 11:58:23 PM »
Do we have an expert in home hemodialysis billing in this Group?  I need help to correctly bill for a home health company who does hemodialysis at patients home and they are out-of-network; commercial insurance only and do not bill Medicare.  Contracted Nurses do the dialysis at patients home. Do I bill with CMS 1500 or UB04? 

Thank you.

Jocelyn

RichardP

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Re: In-home Hemodialysis Billing
« Reply #1 on: August 18, 2015, 05:52:49 AM »
In terms of Medicare, Home Health Agencies are considered Institutional Providers.  As such, they are required to use the UB04.  If the Home Health Agency is approved as a DME supplier, they would submit claims for DMEPOS services on the CMS-1500 Form. 

Each Private Insurance Carrier likely has its own standard.  It may mirror the Medicare standard, or it may not.  You won't know until you ask them.

See Page 5 of this link:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c10.pdf

That link came from here:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/837I-FormCMS-1450-ICN006926.pdf

jpositos

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Re: In-home Hemodialysis Billing
« Reply #2 on: August 25, 2015, 10:33:18 PM »
Thank you.

Any recommendation on a user-friendly web-based software for UB-04 billing that will not break the bank?

Jocelyn

Michele

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Re: In-home Hemodialysis Billing
« Reply #3 on: August 30, 2015, 07:22:57 PM »
Jocelyn,

We use Speedysoft for our UB04 claims.  We have used them for years.  It is very reasonable (I think about $250 - $275).  It has electronic capabilities.  Doesn't have a ton of bells and whistles but it works for our needs.  In all fairness, we have not worked with any other UB04 software.  You can read more at:

http://www.speedysoftusa.com/shop/affiliate.php?id=2&redirect=http://www.speedysoftusa.com/speedyclaims.html 

Disclaimer:  We are an affiliate of Speedy Soft
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jpositos

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Re: In-home Hemodialysis Billing
« Reply #4 on: August 31, 2015, 09:14:27 PM »
Thank you Michelle.  I checked the link and price is good and this might work for the meantime.

Jocelyn

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Re: In-home Hemodialysis Billing
« Reply #4 on: August 31, 2015, 09:14:27 PM »

Michele

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Re: In-home Hemodialysis Billing
« Reply #5 on: September 01, 2015, 01:23:28 PM »
I hope it works out for you.  They have great support too.
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jpositos

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Re: In-home Hemodialysis Billing
« Reply #6 on: September 01, 2015, 04:33:31 PM »
Hi Michelle,

Do you deal with anyone in particular at SpeedySoft?  I called Sales and I keep on getting the voicemail to leave a message. 

Does the UB04 software allow Print to File image so I can use a clearinghouse other than those they recommend?

Do they provide any codes (ICD9/ICD10, HCPCS, Rev) and if not, can I enter and save the codes I need?

Thank you.

Jocelyn

Michele

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Re: In-home Hemodialysis Billing
« Reply #7 on: September 02, 2015, 01:52:29 PM »
I will send out an email to Dan and ask him for a number/person you can speak to. 

I believe you have to enter your own codes, but you build up a database as you go.

I believe you can create an image and use your own clearinghouse, but I'm not sure.  I will get back to you.
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Michele

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Re: In-home Hemodialysis Billing
« Reply #8 on: September 02, 2015, 04:50:51 PM »
I sent you a PM with a number to call.
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jpositos

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Re: In-home Hemodialysis Billing
« Reply #9 on: September 03, 2015, 12:11:12 AM »
Hi Michelle,

Thank you!

I got your message, I called and got the answers I need!

Thank you again!

Jocelyn

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Re: In-home Hemodialysis Billing
« Reply #9 on: September 03, 2015, 12:11:12 AM »

jpositos

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Re: In-home Hemodialysis Billing
« Reply #10 on: September 03, 2015, 08:50:46 PM »
Hi Michelle,

It's me again.  I read on previous posts by you and Alice about Xena web-based software that can do both CMS 1500 and UB04.  Are they still in business and are you still using them?  I can't seem to find their company web site online.

Thanks!

Jocelyn

Michele

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Re: In-home Hemodialysis Billing
« Reply #11 on: September 04, 2015, 10:03:06 AM »
We actually lost touch with them several years back.  I do not know if they are still in business or not. 
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Re: In-home Hemodialysis Billing
« Reply #11 on: September 04, 2015, 10:03:06 AM »