Author Topic: No on Accepting Assignment on Medicare Claims  (Read 947 times)

medbilleror

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No on Accepting Assignment on Medicare Claims
« on: April 01, 2011, 06:26:03 PM »
I looked for this on this forum and didn't see anything so I'm posting my question:

I am having a really hard time enrolling an IDTF In Home Sleep testing business with Medicare.  The IDTF hired a company to do the scoring and interpretation (sleep pulmonologist on staff) of the sleep test and they charge us a flat rate of $45.00 per test (they are used by a lot of sleep labs in the US) and it saves the IDTF money by not paying a separate person to score and then a separate person to do the interpretation.   The main problem is the interpreting physician that is interpreting the results of the sleep test is not cooperating - he/she is not willing to give us the required info Medicare requires for interpreting physician section of the application (SSN, Birthdate).   And now we have to fork up $505.00 to enroll in Medicare as of 04-01-2011.

So an option we are looking at is: If we choose not to enroll in Medicare at this time, Medicare told me that I can still submit claims to them, but would have to check No in the assignment of Benefits box 27, and the check goes to patient and we go after pt for the money, but if I remember right, if the insurance sends the check to pt, do they also list the Dr's name as well on the check (in this case it would be the IDTF Business name)so the patient can't cash the check, they would just sign it over to the IDTF????? And do we get notification from Medicare that they paid the claim and payment went to medicare?  And if we were to bill it this way, do we just bill the 95806 global and not put anything on the claim in box 20 that we are paying this company $45.00 for the test???  This has just been a pain to deal with!!   >:(

Thanks in advance for your help!!!!

Janice
Pacific Medical Billing Solutions, LLC

Michele

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Re: No on Accepting Assignment on Medicare Claims
« Reply #1 on: April 01, 2011, 06:57:24 PM »
I do not believe this information is correct.  You can be non par with Medicare but in order to treat Medicare patients you must enroll in Medicare.  Therefore, the problem is with the interpreting physician.  Really the only way around this is to get another interpreting physician.  If he/she is unwilling to cooperate in the process of getting set up to treat Medicare patients, then he/she is really hindering the IDTF and you need to find a new physician.  My question would be "why are you not willing to cooperate??"

If you are non par with Medicare (and box 27 is checked no) then the money will go to the patient and it will be made out to the patient.  It will not have the IDTF or the Dr's name on the check so the patient can just cash it.

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medbilleror

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Re: No on Accepting Assignment on Medicare Claims
« Reply #2 on: April 01, 2011, 10:04:25 PM »
yes, to be Non Par, I do have to enroll in medicare to have the payment sent to us, but Medicare told me that I can treat a medicare patient if I'm not enrolled in medicare, I just have to check in Box 27 no.  We are having a meeting on Monday with the CEO of the company that will do the scoring and has the interpreting physician.  Hopefully, we can figure something out.