Author Topic: Medicare EDI enrollment  (Read 1439 times)

mthomas

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Medicare EDI enrollment
« on: March 05, 2009, 10:45:50 AM »
Hello all,

Thank you so much for this forum.  I am new to this!  My husband bought a chiropractic office, and his office manager quit one month after he took over.  He like most doctors stinks at business.  Since I'm a software engineer--I'm stuck doing anything computer related :-)

Now my question:

We are trying to get him authorized to  submit claims to medicare...I don't care what method we use, but I can't get a straight answer from anyone.  He pays Mckesson to do his billing, but they don't even have a current submitter ID for medicare.  So I thought I would circumvent Mckesson, and go straight to Medicare and get my own submitter ID and use MedExpress.

This would be fine, but getting enrolled in Medicare EDI is turning out to be a bear...one person told me to only enter my husbands type I NPI and his personal ptan on the form and fax it.  I did that, and now someone else has told me that is wrong I need his type II and his group Ptan, and that all it will not process the way it is. 

Do you know what is the correct answer...Do I need to resubmit the form again, with his group information, and wait another 20 days for it to process?  The issue is that his type I is par and his type II is nonpar.

Also do you know of a way to speed this process up...anyway at all.  We are going to go bankrupt at this point, if I can't figure out a way to get this process sped up.  I am desparate, and this is not helping anything...LOL

Thanks!

Michelle

Michele

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Re: Medicare EDI enrollment
« Reply #1 on: March 06, 2009, 09:43:32 PM »
Hi,
   It will depend on what information Medicare has him under.  If they have him under his individual NPI and his PTAN is an individual linked to the individual NPI then that is the info you need on the form.  But if he bills under a tax ID, or EIN number, and medicare has the group npi (type II) linked to his PTAN then you would need that info on the form.  If you are unsure you should call the customer service number at Medicare and ask them.  It really shouldn't be that difficult to get set up with their EDI, but each carrier varies.  Just call, get the correct information, complete the paperwork, and then stay on top of them.

Good luck!

Michele
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PMRNC

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Re: Medicare EDI enrollment
« Reply #2 on: March 08, 2009, 09:00:35 AM »
Just another note.. your NPI info has to match your IRS info EXACTLY or it results in delays and problems.
Also Medicare won't allow you to have two submitters, so you might have to formerly disconnect one first!
Linda Walker
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dedwards

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Re: Medicare EDI enrollment
« Reply #3 on: April 30, 2009, 04:50:08 PM »
I recently went through the same Medicare/EDI experience.  It was horrible!  Good luck.
One piece of advice is to follow-up with Medicare!

dedwards

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Re: Medicare EDI enrollment
« Reply #4 on: April 30, 2009, 04:58:31 PM »
Are you familiar with Compulink software?  Just wondered. 

Michele

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Re: Medicare EDI enrollment
« Reply #5 on: April 30, 2009, 09:36:43 PM »
I am not familiar with that software.

Michele
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