Author Topic: Medicare and Medicaid  (Read 1775 times)

fguard

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Medicare and Medicaid
« on: April 10, 2008, 05:25:43 PM »
I have worked as a senior claims examiner for Prudential/Aetna for over 12 years and have been a medical biller for the the last 5 years. While I know about the billing process I am not sure about setting up things on the business end. I have access to United Healthcare, and have applied for access to Aetna and Availity, but am not sure what is needed for Medicare and Medicaid. Funds are also a issue for me right now and would like any pointers to get this going. Thanks Fran

Michele

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Re: Medicare and Medicaid
« Reply #1 on: April 17, 2008, 06:53:38 AM »
Hi Fran,
  If funds are an issue you may want to contact your local Medicare about using the free software that they offer to submit claims electronically.  It is a separate stand alone program from your Practice Management Software so you will need to double enter everything, but it is certainly a cheap alternative.  Also, Medicaid usually allows you to enter claims thru the web site.  Again, double entry but cheap. 

   Alice and I started out together because I had a background similar to yours along with a computer programming degree, and Alice had the business background.  Worked out great!

Good luck
Michele
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TOWERMED

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Re: Medicare and Medicaid
« Reply #2 on: April 19, 2008, 02:39:53 PM »
What website would I go to in order to find out about filing electronically thru Medicare and Medicaid? :-\ ???

Cady

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Re: Medicare and Medicaid
« Reply #3 on: April 19, 2008, 05:49:08 PM »
I did not start billing yet, but in my understanding I would contact California Medicaid for Medicaid Claims ( Medi-Cal: www.medi-cal.ca.gov/contact.asp ) and  the CMS Region 9 - San Francisco (www.cms.hhs.gov/RegionalOffices/) or his contractor and ask how to bill Medicare Claims in California..
« Last Edit: June 03, 2008, 09:06:59 PM by Cady »

Michele

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Re: Medicare and Medicaid
« Reply #4 on: April 22, 2008, 09:35:04 PM »
That's a great suggestion Cady, thanks!

Also, if you can't find the info on the website you can call the Medicare carrier and ask for the phone number for their EDI department.  They will direct you to what you need to do.

Michele
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