Medical Billing Forum

General Category => General Questions => Topic started by: jpositos on August 17, 2015, 08:58:23 PM

Title: In-home Hemodialysis Billing
Post by: jpositos on August 17, 2015, 08:58:23 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
Title: Re: In-home Hemodialysis Billing
Post by: RichardP on August 18, 2015, 02:52:49 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
Title: Re: In-home Hemodialysis Billing
Post by: jpositos on August 25, 2015, 07:33:18 PM
Thank you.

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

Jocelyn
Title: Re: In-home Hemodialysis Billing
Post by: Michele on August 30, 2015, 04:22:57 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
Title: Re: In-home Hemodialysis Billing
Post by: jpositos on August 31, 2015, 06:14:27 PM
Thank you Michelle.  I checked the link and price is good and this might work for the meantime.

Jocelyn
Title: Re: In-home Hemodialysis Billing
Post by: Michele on September 01, 2015, 10:23:28 AM
I hope it works out for you.  They have great support too.
Title: Re: In-home Hemodialysis Billing
Post by: jpositos on September 01, 2015, 01:33:31 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
Title: Re: In-home Hemodialysis Billing
Post by: Michele on September 02, 2015, 10:52:29 AM
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.
Title: Re: In-home Hemodialysis Billing
Post by: Michele on September 02, 2015, 01:50:51 PM
I sent you a PM with a number to call.
Title: Re: In-home Hemodialysis Billing
Post by: jpositos on September 02, 2015, 09:11:12 PM
Hi Michelle,

Thank you!

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

Thank you again!

Jocelyn
Title: Re: In-home Hemodialysis Billing
Post by: jpositos on September 03, 2015, 05:50:46 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
Title: Re: In-home Hemodialysis Billing
Post by: Michele on September 04, 2015, 07:03:06 AM
We actually lost touch with them several years back.  I do not know if they are still in business or not.