Author Topic: Multiple medicare billers for same provider  (Read 1552 times)

Mdrei

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Multiple medicare billers for same provider
« on: February 06, 2012, 10:44:28 PM »
Hi All,

First let me say that I really like the forum; it has a wealth of information.

I have recently started my own medical billing service and am about to sign up my first provider. Since this is my first client, I do not want to take on all his billing needs yet.  He currently has a billing service that he wants to move away from.  The plan would be for me to start doing a couple of claims per day (new patients only), and if things go well take over in a couple of months.

This specific provider has 95% of patients on Medicare with a secondary.  Almost all his services are provided in-hospital and only 5% at the practice. 
I am trying to figure the Medicare Submitter ID.  I will be using a clearinghouse, so my understanding is that I will use their submitter ID.
I assume that the current billing service is also using a clearinghouse since they use AdvancedMd.

What would I need to do regarding Medicare Submitter IDs in order to have both billing services submit successfully.

Thanks,
.Tibi
« Last Edit: February 06, 2012, 11:25:18 PM by Mdrei »

PMRNC

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Re: Multiple medicare billers for same provider
« Reply #1 on: February 07, 2012, 08:09:36 AM »
No, the Submitter ID is like an electronic signature of assurance to Medicare, you cannot use another submitter ID. Your clearinghouse should provide you with the necessary paperwork for EDI enrollment. You will also need to make certain Medicare is informed of the change/addition of billing agent.

One final note of caution when there is another billing company in the mix. STAY out of all business/contractual issues with the other billing company. Make sure your contract states such and that you will be acting as a third party to the PROVIDER only. This means it is in YOUR best interest not to have communications with the billing company. Many times providers will expect you to be in touch with the other billing company and this is always a disaster waiting to happen. Provider's have a responsibility to uphold all contractual agreements and that can get sticky when adding or changing a billing company. Decide where you will begin, make sure your contract is air tight to protect you.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

Mdrei

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Re: Multiple medicare billers for same provider
« Reply #2 on: February 07, 2012, 09:09:54 AM »
Thanks Linda!

So basically each one of the billing services will use their own Submitter IDs.  The provider has already signed the Medicare form to add me as an additional submitter.

The contract is well written and there is zero expectation for us to work with the other service. Actually the provider asked for full confidentiality as he does not want any kind of tension.

Cheers,
.Tibi