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General Questions / Re: I beg for your help! BCBS, GA Medicad, and deductibles
« Last post by rballinger1 on November 13, 2017, 10:48:22 PM »
We bill both BCBS of GA, and Medicaid/Medicaid HMO Plans.  If the patient has Medicaid it is always billed after the primary (BCBS in this case).  If the provider does not participate with Medicaid, or if the service is not covered by Medicaid you can collect from the patient upfront but the patient must sign an ABN, or advanced notice of responsibility and include the reason the patient is responsible.
General Questions / Re: Claim is denied for CO-16
« Last post by rballinger1 on November 13, 2017, 10:31:32 PM »
What type of provider render the services?  The only time I have ever seen the MA136 used is when the supervising physician was not properly identified in Box 17.

The qualifier DQ should be listed along with the supervising physicians name and NPI #.  If the rendering provider does not require a supervising physician you might consider reviewing Box 17 to see if the DQ modifier was entered in error.  If you must contact Medicare about the claim, I would ask the representative to review Box 17 and provide you with the qualifier, provider's name and NPI appearing in their system.

I understand your frustration, it is becoming more difficult to get questions answered when calling Medicare.
Starting Your Own Medical Billing Business / Re: Patient Credit Card Payment
« Last post by Powerade_993 on November 13, 2017, 11:12:30 AM »
Such helpful information!! A huge thank you to both who responded. This was the one process I was confused on. I totally understand now. Thank you!!
Starting Your Own Medical Billing Business / Re: Patient Credit Card Payment
« Last post by PMRNC on November 13, 2017, 07:20:20 AM »
Agree with Michele, if the merchant has a "virtual terminal" you could do it that way. I personally don't process credit card payments for my clients/patients, they call directly to the office and they process them. I prefer to keep the collections side of things outside of my contractual services.
Starting Your Own Medical Billing Business / Re: Patient Credit Card Payment
« Last post by Michele on November 13, 2017, 07:17:15 AM »
I'm not sure how square works other than they have the attachment that can be used for swiping cards.  Do they also have a system that you can log into from a computer to process manual payments?  If they do, then you would just log in and manually punch in the information for the payment.

We have different set ups with our providers depending on their system. We have some providers that don't take credit cards so they ask us to process the payment (we have a merchant system ourselves) and we credit them the amount of the payment minus a 3.5% fee (the cost of accepting the credit card). 

Some of our providers that take credit cards directly in the office prefer to also take the call so we refer the patient to call the office directly.  Some providers wish us to take all payment information and then give it to them in their office to process.
Starting Your Own Medical Billing Business / Patient Credit Card Payment
« Last post by Powerade_993 on November 12, 2017, 04:34:49 PM »
If a patient calls to make a payment on their account by credit card, how does this work? Do I need an addition software to process this payment? In my situation I will be doing all the billing out of the providers EHR system. This software is capable of posting the payment but not capable to actually processing the payment. The providers have square attached to their phones and iPads for collection of payment....I canít imagine I refer the patient to the provider for the processing of this payment.
Starting Your Own Medical Billing Business / Re: Fees
« Last post by PMRNC on November 12, 2017, 11:43:54 AM »
If you search this forum, you'll find a lot of posts about what and how to charge. Some states have fee-splitting prohibitions that don't allow physicians to enter into contracts on a % rate. I am in one of those states (NY) I charge flat fee which is based on an hourly rate.
Starting Your Own Medical Billing Business / Fees
« Last post by Jennmarie42 on November 10, 2017, 11:42:19 AM »
So I am curious as to what going rates are and I am having a terrible time finding them. Wondering if anyone can give me examples of how they bill and rates? (i.e. Flat rate, hourly or percentage)
General Questions / Re: DME - Modifier Help, Please
« Last post by Michele on November 10, 2017, 07:05:00 AM »
Are the items for the same leg/foot?  If they are for separate limbs then they are looking for the RT/LT modifier.  If they are for the same limb, I'm not sure.   By description they do seem to be inclusive but since they reviewed and stated appropriate modifier could be submitted it sounds as if they agree that they could be allowed separately.  I found a list of DME modifiers, but I'm not seeing one for this situation.  Maybe you will spot it:

General Questions / Re: Medical billing question
« Last post by veronicadorovon on November 09, 2017, 11:31:07 PM »
It totally depends on the type of the claim, amount to be claimed, span of the insurance plan and many other things. Try to verify your claim and then send it again.
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