Author Topic: Billing Medicare and Medicaid  (Read 2544 times)

DavidZ

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Billing Medicare and Medicaid
« on: September 01, 2009, 09:33:56 AM »
As a billing company do you have to have authorized to bill medicare/medicaid?
If yes, what is the process?

How do you enroll a provider in PartB Medicare, what is the process and how long does it usually take?

PMRNC

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Re: Billing Medicare and Medicaid
« Reply #1 on: September 01, 2009, 10:00:43 AM »
A billing company does not need to be enrolled, but they should be listed on the enrollment as the billing agent.

A provider can enroll now online using the PECOS http://www.cms.hhs.gov/MedicareProviderSupEnroll/
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: Billing Medicare and Medicaid
« Reply #2 on: September 01, 2009, 08:05:55 PM »
The process to enroll a provider in Medicare varies depending on the carrier.  I have some go thru in as little as 4 weeks, but most are anywhere from 6 wks to 12 wks.

Michele
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DavidZ

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Re: Billing Medicare and Medicaid
« Reply #3 on: September 02, 2009, 09:01:35 AM »
Thank you guys,
The cases here are: there is that a provider that has medicare/medicaid patients and a inhouse biller that they want to replace by outsourcing to us. The question was posed to us: how long will it take for you to take over and start billing.(medicare/medicaid included)
What do you do in this case, when the client wants you to take over ASAP.
Given that there will be a delay of about 3-4 weeks, how do you present that and still get the client?

Also what happens if the provider that you are trying to get has been enrolled in medicare for a couple years and would like to switch billing companies. What is the process here and how long should it take?

PMRNC

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Re: Billing Medicare and Medicaid
« Reply #4 on: September 02, 2009, 10:26:47 AM »
There is always a slight delay when there is a change such as going outsourced. The Medicare Enrollment applications have a spot where the new billing agent is listed. In addition you have to connect that enrollment to your clearinghouse, the delay is simply because you can't have two submission processes (2 clearinghouses, ..etc)
The average time for such a change is only about 2 weeks. NEW enrollments (doctors NOT enrolled previously) are a bit longer. The claims can still be entered but what I do is put them in "hold" status until we are ready to roll.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

DavidZ

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Re: Billing Medicare and Medicaid
« Reply #5 on: September 02, 2009, 10:34:38 AM »
Got it, big help again thanks!
David

Anne

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Re: Billing Medicare and Medicaid
« Reply #6 on: September 03, 2009, 04:34:10 PM »
how can I find a fee sched. for Medicare?  I've tried searching website, but can't bring up where it says how much will be paid.  I'm looking for a list - reimbursement sched. for PT, OT and ST for Secure horizons, Medicare.  I know it's admins. by United healthcare but just can't find out how much my prov. will be paid if she enrolls as a provider.  She asked me to find out before filling out applications, etc.

PMRNC

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Re: Billing Medicare and Medicaid
« Reply #7 on: September 03, 2009, 09:38:36 PM »
Medicare's fee schedules are on their website they are in huge zip files.  www.cms.gov
Not sure about Secure Horizons, is that a Medicare Managed care plan maybe? some carriers won't give you the fee schedule until you do a letter of intent first.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Michele

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Re: Billing Medicare and Medicaid
« Reply #8 on: September 04, 2009, 07:47:04 AM »
I would call Secure Horizons and ask if they will provide a fee schedule.  Like Linda said, some will but they may require the letter of intent first.

Michele
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