Author Topic: medicaid billing agent number  (Read 7894 times)

pamelawt3

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Re: medicaid billing agent number
« Reply #15 on: April 08, 2010, 07:17:28 AM »
charlene, i am in NC and getting started with my billing service. what forms do i use to let Medicaid know that i will be filing claims.
thanks- pam

Pay_My_Claims

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Re: medicaid billing agent number
« Reply #16 on: April 08, 2010, 07:47:24 AM »
Pam,
You don't need a billing agent number for NC Medicaid. Please feel free to email me or call me. If you use NC Webclaims for submissions, just put in your billing information this way when you have any problems NC Medicaid will call you. I had some NPI unresolved issues, and they called my provider first, but realized I was doing the billing. I love the fact they call me, so that it does not "scare" the provider. This is only if you will be using NC webclaims.

There are however other things you need to be aware of for NC to do billing from home (if that is your intention)

pamelawt3

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Re: medicaid billing agent number
« Reply #17 on: April 08, 2010, 07:52:47 AM »
i'm in NC. where do i get the medicaid enrollment form in order to submit claims as a billing service. i've been on the website but can not find the forn. i see for providers but not billing service.

Pay_My_Claims

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Re: medicaid billing agent number
« Reply #18 on: April 08, 2010, 08:06:04 AM »
You don't need one.  When you decide which software to use, you will submit an EDI form to EDS via your software vendor to get approval to send claims in electronically for your provider.

blhoffman

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Re: medicaid billing agent number
« Reply #19 on: April 09, 2010, 08:53:42 AM »
I work for a Home Health Care Agency that has their own billing department and I worked for Renal Dialysis. We have a PA Medicaid number - several actually depending on the age of the patient and waivers.

So, If I was to start my own billing company, would I need my own PA Medicaid number?

What if billing for different providers - eventually? Would I bill for different practices under my PA Medicaid number?

I guess I thought I would just bill under the provider's number they should already have in place in most cases.
« Last Edit: April 11, 2010, 01:56:25 PM by blhoffman »

Michele

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Re: medicaid billing agent number
« Reply #20 on: April 11, 2010, 01:07:43 PM »
You do use the provider's medicaid number, but some states (liek NY) also require a billing service to be assigned a number as well, strictly to identify them as a billing service.  I'm not sure on PA.

Michele
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Pay_My_Claims

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Re: medicaid billing agent number
« Reply #21 on: April 11, 2010, 03:45:40 PM »
You do use the provider's medicaid number, but some states (liek NY) also require a billing service to be assigned a number as well, strictly to identify them as a billing service.  I'm not sure on PA.

Michele


Michelle, I am actually contacting NC Medicaid to determine if I can obtain a user-id/pw for myself for their system. Its so hard keeping up with the providers number. I won't have a "medicaid" number, but for providers that have not already signed up to bill using webclaims, it will save me time.

Pay_My_Claims

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Re: medicaid billing agent number
« Reply #22 on: April 15, 2010, 08:40:19 PM »
Update..NC Medicaid will allow me as a billing agent to have my own submitter ID/PW to webclaims so that I can bill all of my providers out of one system. This will be so good for me now that I don't have to remember all those freaking numbers. I am also getting my blue-e auths...Life is good.


Michele

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Re: medicaid billing agent number
« Reply #23 on: April 16, 2010, 07:44:41 AM »
Yey Charlene!   ;D
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Pay_My_Claims

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Re: medicaid billing agent number
« Reply #24 on: April 16, 2010, 08:07:44 AM »
Yey Charlene!   ;D

*Does Happy dance*

PMRNC

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Re: medicaid billing agent number
« Reply #25 on: April 16, 2010, 02:53:51 PM »
Quote
I understand that, but FLorida is because of the fee splitting crap. I'm a believer in specialties also. One of the things that I stress to anyone that I mentor to is to familiarize yourself with the medicaid rules of the state you are billing for. Each state has different rules. We have a Cap Medicaid program in NC. I don't know if any other state has that. If they do, it may be called something else, and the rules are different. I can be flexible in my border states and have plenty of business. I had a friend who took on a NC provider (she is from another state) and he does a lot of medicaid. She had to rebill those claims several times because she just wasn't familiar with how we do Medicaid in NC. Another reason as I stated, its just risky enough when you deal with providers paying you. I just prefer local providers personally.

I would tend to agree with you a few years back, however I've now had a nice taste of getting paid for my work so I'd never go back to % billing ever again, and I'm in NY so that fee splitting thing doesn't scare me off at all. It's great marketing tool actually because I've talked to providers who were completely unaware that entering into those contracts is illegal for them. Plus if you are In NJ or NY most likely you are going to work with both states because many who live in NJ commute to NJ to work and even visa versa. I also like the diversity, if you can deal with multi-state Medicaid, Workers Comp, PI, etc..you have an edge on the competition.
Linda Walker
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Pay_My_Claims

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Re: medicaid billing agent number
« Reply #26 on: April 16, 2010, 03:00:36 PM »
Oh yes, I know the rules for various states for Medicaid (10 years of hospital insurance & authorizations). My issues is collecting. I want to be within BEATDOWN range for my money!! I'm doing well within NC (1 SC provider), I just don't extend outside of the States. Now if they contact me..LOL. Also I am glad I never did the %. When I got into the billing thats all I heard, but I'm glad that I ventured out on my owl little path and decided to develop a new methodology of payments. Everyone that I have dealt with in the past always talking about "well you can bring in this and that" OK, I just signed an Optometrist for AR-Recovery, guess what happens when I start to review his AR???? His staff was forgetting to post payments that were EFT'd to them. OK thats a no pay...I don't get paid for that. This is also why I charge a downpayment on AR--Recovery for cases such as this. You have to get paid for your time!!

PMRNC

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Re: medicaid billing agent number
« Reply #27 on: April 16, 2010, 03:02:48 PM »
Today you shouldn't have problem getting paid, there are a ton of options now, credit card, direct withdrawal. I have direct deposit set up with my clients, they love it, I love it :) If you mean reimbursement from the various states, where you file them shouldn't make a difference. Maybe i misunderstood.
Linda Walker
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