Medical Billing Forum

General Category => General Questions => Topic started by: gderilus on April 04, 2010, 12:35:21 PM

Title: medicaid billing agent number
Post by: gderilus on April 04, 2010, 12:35:21 PM
I have a medical billing business,Do I need to have a medicaid billing agent provider number in order to send claims or the provider can notify medicaid.Do I need to apply with medicaid as a billing agent or the provider has to add me to his application.
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 04, 2010, 03:33:28 PM
NOT sure what you are speaking of exactly, but there is no "billing #" in NC. you do have to be enrolled to bill NC medicaid with an edi application or an application to use webclaims. However you submit with the providers user id/pw
Title: Re: medicaid billing agent number
Post by: Michele on April 04, 2010, 09:01:01 PM
In NY, you must enroll to get a "Medicaid number" issued.  Each state varies.  You will have to check with your state Medicaid.

Michele
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 05, 2010, 05:24:39 PM
In NY, you must enroll to get a "Medicaid number" issued.  Each state varies.  You will have to check with your state Medicaid.

Michele


is that for the billing agent, or for the provider??
Title: Re: medicaid billing agent number
Post by: Michele on April 05, 2010, 08:24:57 PM
As a billing service we had to enroll and get assigned a medicaid number.

Michele
Title: Re: medicaid billing agent number
Post by: PMRNC on April 05, 2010, 08:56:44 PM
Yeah in NY we have to have our own number, same with PA, but PA Medicaid WAS much easier to deal with ..they were actually awesome!
Title: Re: medicaid billing agent number
Post by: blhoffman on April 05, 2010, 09:29:55 PM
I have to agree, PA Medicaid really tries to work with you and solve whatever problem you have ASAP. Wish that was the same for some commercial insurance plans.  :P
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 05, 2010, 09:47:42 PM
Yeah in NY we have to have our own number, same with PA, but PA Medicaid WAS much easier to deal with ..they were actually awesome!


You have to have a medicaid provider number as a billing agent???
Title: Re: medicaid billing agent number
Post by: PMRNC on April 06, 2010, 10:44:59 AM
Quote
You have to have a medicaid provider number as a billing agent???

Yes, we (Billing Agency) have to submit the Service Bureau Enrollment
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 06, 2010, 06:28:57 PM
*scratches off NY & NJ for billing states*
Must be a northern thang........I so love the country!!
Title: Re: medicaid billing agent number
Post by: PMRNC on April 06, 2010, 07:33:39 PM
It's not such a big deal :)  I dont' have any problems with NY Medicaid.... ****KNOCKS WOOD*****
Title: Re: medicaid billing agent number
Post by: Michele on April 07, 2010, 06:58:24 AM
Yeah, it wasn't a problem (and isn't a problem) for us either.  Easy process to go thru and hasn't been any problem since.  ****POUNDING ON WOOD*****
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 07, 2010, 04:18:09 PM
LOL, I HATED NY medicaid when I worked at the hospital. There are just some states I just don't bother with, NY, NJ and Florida are three of them. I also prefer to stay local in case I have to beat down a physician for my money.
Title: Re: medicaid billing agent number
Post by: PMRNC on April 07, 2010, 07:16:15 PM
Florida Medicare and Medicaid are actually really good! I had a client who used to practice in Florida in the winters and I would do the billing from NJ. Never had a problem, in fact I had easier time with his Florida patients. LOL But that was long before NJ came up with all their regulations. NY isn't so bad and I love CT as well.

States that have more regulations are actually good for our reputation, it holds us accountable which therefore makes our profession more reputable. So I can't say there isn't a state I wouldn't work for..where there are hoops to jump through it just gives me more credibility.
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 07, 2010, 07:52:31 PM
Florida Medicare and Medicaid are actually really good! I had a client who used to practice in Florida in the winters and I would do the billing from NJ. Never had a problem, in fact I had easier time with his Florida patients. LOL But that was long before NJ came up with all their regulations. NY isn't so bad and I love CT as well.

States that have more regulations are actually good for our reputation, it holds us accountable which therefore makes our profession more reputable. So I can't say there isn't a state I wouldn't work for..where there are hoops to jump through it just gives me more credibility.

I understand that, but FLorida is because of the fee splitting crap. I'm a believer in specialties also. One of the things that I stress to anyone that I mentor to is to familiarize yourself with the medicaid rules of the state you are billing for. Each state has different rules. We have a Cap Medicaid program in NC. I don't know if any other state has that. If they do, it may be called something else, and the rules are different. I can be flexible in my border states and have plenty of business. I had a friend who took on a NC provider (she is from another state) and he does a lot of medicaid. She had to rebill those claims several times because she just wasn't familiar with how we do Medicaid in NC. Another reason as I stated, its just risky enough when you deal with providers paying you. I just prefer local providers personally.
Title: Re: medicaid billing agent number
Post by: pamelawt3 on April 08, 2010, 07:17:28 AM
charlene, i am in NC and getting started with my billing service. what forms do i use to let Medicaid know that i will be filing claims.
thanks- pam
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 08, 2010, 07:47:24 AM
Pam,
You don't need a billing agent number for NC Medicaid. Please feel free to email me or call me. If you use NC Webclaims for submissions, just put in your billing information this way when you have any problems NC Medicaid will call you. I had some NPI unresolved issues, and they called my provider first, but realized I was doing the billing. I love the fact they call me, so that it does not "scare" the provider. This is only if you will be using NC webclaims.

There are however other things you need to be aware of for NC to do billing from home (if that is your intention)
Title: Re: medicaid billing agent number
Post by: pamelawt3 on April 08, 2010, 07:52:47 AM
i'm in NC. where do i get the medicaid enrollment form in order to submit claims as a billing service. i've been on the website but can not find the forn. i see for providers but not billing service.
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 08, 2010, 08:06:04 AM
You don't need one.  When you decide which software to use, you will submit an EDI form to EDS via your software vendor to get approval to send claims in electronically for your provider.
Title: Re: medicaid billing agent number
Post by: blhoffman on April 09, 2010, 08:53:42 AM
I work for a Home Health Care Agency that has their own billing department and I worked for Renal Dialysis. We have a PA Medicaid number - several actually depending on the age of the patient and waivers.

So, If I was to start my own billing company, would I need my own PA Medicaid number?

What if billing for different providers - eventually? Would I bill for different practices under my PA Medicaid number?

I guess I thought I would just bill under the provider's number they should already have in place in most cases.
Title: Re: medicaid billing agent number
Post by: Michele on April 11, 2010, 01:07:43 PM
You do use the provider's medicaid number, but some states (liek NY) also require a billing service to be assigned a number as well, strictly to identify them as a billing service.  I'm not sure on PA.

Michele
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 11, 2010, 03:45:40 PM
You do use the provider's medicaid number, but some states (liek NY) also require a billing service to be assigned a number as well, strictly to identify them as a billing service.  I'm not sure on PA.

Michele


Michelle, I am actually contacting NC Medicaid to determine if I can obtain a user-id/pw for myself for their system. Its so hard keeping up with the providers number. I won't have a "medicaid" number, but for providers that have not already signed up to bill using webclaims, it will save me time.
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 15, 2010, 08:40:19 PM
Update..NC Medicaid will allow me as a billing agent to have my own submitter ID/PW to webclaims so that I can bill all of my providers out of one system. This will be so good for me now that I don't have to remember all those freaking numbers. I am also getting my blue-e auths...Life is good.

Title: Re: medicaid billing agent number
Post by: Michele on April 16, 2010, 07:44:41 AM
Yey Charlene!   ;D
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 16, 2010, 08:07:44 AM
Yey Charlene!   ;D

*Does Happy dance*
Title: Re: medicaid billing agent number
Post by: PMRNC on April 16, 2010, 02:53:51 PM
Quote
I understand that, but FLorida is because of the fee splitting crap. I'm a believer in specialties also. One of the things that I stress to anyone that I mentor to is to familiarize yourself with the medicaid rules of the state you are billing for. Each state has different rules. We have a Cap Medicaid program in NC. I don't know if any other state has that. If they do, it may be called something else, and the rules are different. I can be flexible in my border states and have plenty of business. I had a friend who took on a NC provider (she is from another state) and he does a lot of medicaid. She had to rebill those claims several times because she just wasn't familiar with how we do Medicaid in NC. Another reason as I stated, its just risky enough when you deal with providers paying you. I just prefer local providers personally.

I would tend to agree with you a few years back, however I've now had a nice taste of getting paid for my work so I'd never go back to % billing ever again, and I'm in NY so that fee splitting thing doesn't scare me off at all. It's great marketing tool actually because I've talked to providers who were completely unaware that entering into those contracts is illegal for them. Plus if you are In NJ or NY most likely you are going to work with both states because many who live in NJ commute to NJ to work and even visa versa. I also like the diversity, if you can deal with multi-state Medicaid, Workers Comp, PI, etc..you have an edge on the competition.
Title: Re: medicaid billing agent number
Post by: Pay_My_Claims on April 16, 2010, 03:00:36 PM
Oh yes, I know the rules for various states for Medicaid (10 years of hospital insurance & authorizations). My issues is collecting. I want to be within BEATDOWN range for my money!! I'm doing well within NC (1 SC provider), I just don't extend outside of the States. Now if they contact me..LOL. Also I am glad I never did the %. When I got into the billing thats all I heard, but I'm glad that I ventured out on my owl little path and decided to develop a new methodology of payments. Everyone that I have dealt with in the past always talking about "well you can bring in this and that" OK, I just signed an Optometrist for AR-Recovery, guess what happens when I start to review his AR???? His staff was forgetting to post payments that were EFT'd to them. OK thats a no pay...I don't get paid for that. This is also why I charge a downpayment on AR--Recovery for cases such as this. You have to get paid for your time!!
Title: Re: medicaid billing agent number
Post by: PMRNC on April 16, 2010, 03:02:48 PM
Today you shouldn't have problem getting paid, there are a ton of options now, credit card, direct withdrawal. I have direct deposit set up with my clients, they love it, I love it :) If you mean reimbursement from the various states, where you file them shouldn't make a difference. Maybe i misunderstood.