Author Topic: Medicare billing  (Read 1039 times)

ste

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Medicare billing
« on: August 27, 2010, 01:48:44 PM »
A patient has Medicare as 1º and BCBS as 2º. The provider, from a specialty not recognized by Medicare (acupuncture), believes she can submit a claim to Medicare and after it is denied submit a secondary claim to BCBS and get paid for her services.
The first sentence in the first chapter of Michelle’s e-book on Medicare enrollment states, “In order for a medical provider to provide services to a Medicare patient, they must be a Medicare provider.” Since the above provider is not a Medicare provider isn’t her idea of getting paid by the 2º insurance little more than a pipe dream, not to mention the possible legal entanglements?

PMRNC

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Re: Medicare billing
« Reply #1 on: August 27, 2010, 10:04:26 PM »
You need to have patient sign ABN.
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: Medicare billing
« Reply #2 on: August 28, 2010, 02:49:49 PM »
Sorry, that statement applies to provider types that are recognized by Medicare.  In this case the provider should be able to bill the secondary directly since their specialty is not recognized by Medicare. 

Also, Linda is right, get the ABN on file too.

Michele
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PMRNC

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Re: Medicare billing
« Reply #3 on: August 28, 2010, 03:50:33 PM »
Yup, my bad.. lol  Sometimes if a provider isn't recognized by Medicare the secondary will still give you a problem and want the EOB, in that case I usually copy the Medicare policy on those and send it off with a letter.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com