Author Topic: medicare eligibility check  (Read 4095 times)

Philip

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medicare eligibility check
« on: July 02, 2009, 02:11:29 PM »
How will I get the contact information of  all  medicare providers? Is there any provie look-up website ? Is there any database to download from the net? I am new to Billing . Anybody please help? Thanks In advance

PMRNC

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Re: medicare eligibility check
« Reply #1 on: July 02, 2009, 05:02:58 PM »
www.cms.gov

Or if you want a particular state/carrier  "google" :)
Linda Walker
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Pay_My_Claims

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Re: medicare eligibility check
« Reply #2 on: July 02, 2009, 05:42:32 PM »
How will I get the contact information of  all  medicare providers? Is there any provie look-up website ? Is there any database to download from the net? I am new to Billing . Anybody please help? Thanks In advance

Are you looking for providers that accept medicare??? I'm confused as to your subject is eligibility check. Are you trying to verify if a client has medicare???

PMRNC

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Re: medicare eligibility check
« Reply #3 on: July 02, 2009, 06:08:38 PM »
I think I am half brain dead this week. I thought they said "carriers"

I'm going to take a guess that they are looking for a marketing list?

Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: medicare eligibility check
« Reply #4 on: July 03, 2009, 06:55:15 AM »
Guess they are...I know I was baffled!!

Philip

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Re: medicare eligibility check
« Reply #5 on: July 03, 2009, 07:52:23 AM »
I am actually was trying to check medicare eligibility for Homehealth(using DDE) when a patient choose to transfer their service to us and when they show that patient has another provider, how do I find out the details about that provider? Such as the facility name, contact and phone and fax numbers. Please advice.Thanks

PMRNC

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Re: medicare eligibility check
« Reply #6 on: July 03, 2009, 08:37:36 AM »
Not sure on DME  ???  but when I dealt with other providers for clients that worked in nursing homes, we got a face sheet with all the referring physician information on it.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Pay_My_Claims

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Re: medicare eligibility check
« Reply #7 on: July 03, 2009, 08:58:25 AM »
I am actually was trying to check medicare eligibility for Homehealth(using DDE) when a patient choose to transfer their service to us and when they show that patient has another provider, how do I find out the details about that provider? Such as the facility name, contact and phone and fax numbers. Please advice.Thanks

We use the IVR for same or similar equipment (DME) (using HCPCS) codes. When it shows that information I call Medicare provider services and they will give me the date of service, the provider, and the phone number. They are supposed to now list snf, hospice on the IVR, and on their eligibility system, eventually list same or similar.

Philip

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Re: medicare eligibility check
« Reply #8 on: July 03, 2009, 10:35:55 AM »
Thanks a lot for your Reply. Now I got it . This is the first time I am using medicare DDE( Direct Data Entry) to check  eligibility for  Homehealth . I am new to billing.In Homehelath, we need to check th eligibility of patients before we admit them in our facility. Sometimes the patient will have HMO or PPO . When I check eligibility, , I was trying to figure out that also ( which HMO or PPO the patient has) . In this case also ,can I   call medicare provider services to get the information of that HMO or PPO ? Please advise. Thanks in advance

Pay_My_Claims

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Re: medicare eligibility check
« Reply #9 on: July 03, 2009, 11:43:53 AM »
Thanks a lot for your Reply. Now I got it . This is the first time I am using medicare DDE( Direct Data Entry) to check  eligibility for  Homehealth . I am new to billing.In Homehelath, we need to check th eligibility of patients before we admit them in our facility. Sometimes the patient will have HMO or PPO . When I check eligibility, , I was trying to figure out that also ( which HMO or PPO the patient has) . In this case also ,can I   call medicare provider services to get the information of that HMO or PPO ? Please advise. Thanks in advance

Yes, you can always call the IVR to obtain that information. It will give you the information about the HMO, PPO's and also other insurance primary. There are other eligibility portals to check medicare. Brightree is free for DME and HME provider, Passports(pay per usage), and the CSI/BE that is offered by Medicare (yearly fee, unlimited usage)

Good blessings to you

Philip

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Re: medicare eligibility check
« Reply #10 on: July 04, 2009, 05:31:57 PM »
Thanks a lot for your reply. I am going to try that on monday. We have passport. I will get the provider information from the passport. After that I will call the IVR .Thank you. May God Bless you all. Have a nice weekend.

Pay_My_Claims

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Re: medicare eligibility check
« Reply #11 on: July 04, 2009, 07:05:23 PM »
Thanks a lot for your reply. I am going to try that on monday. We have passport. I will get the provider information from the passport. After that I will call the IVR .Thank you. May God Bless you all. Have a nice weekend.

You are welcome, enjoy as well!

Amit_Nischal

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Re: medicare eligibility check
« Reply #12 on: July 16, 2009, 02:11:25 PM »
You can try www.nynpi.com. The only requirement is provider's full name. I did the random check on out of state providers, did able to get the details.

Thanks,
Amit

Pay_My_Claims

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Re: medicare eligibility check
« Reply #13 on: July 16, 2009, 03:53:09 PM »
You can try www.nynpi.com. The only requirement is provider's full name. I did the random check on out of state providers, did able to get the details.

Thanks,
Amit

That site won't give you eligibility information. He wants to know when a client presents with Medicare if they are enrolled in an HMO or PFFS plan. A lot of time patients still give you the Medicare card and they actually have a PFFS

Amit_Nischal

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Re: medicare eligibility check
« Reply #14 on: July 17, 2009, 08:50:49 AM »
Charlene,

Thanks for correcting me. Let me check with my resources to find out the required information.

Amit