Billing Secondary/Medicaid

[Sabrina]

HI to all,

I am billing for a LSCW code is 90801AJ for Medicare, secondary is Medicaid of NC, Can I leave the modifier on the claim and send with the EOB or bill without.   

[Michele]

Hi,
   You can leave the modifier on.  I haven't billed NC Medicaid but in all other states I have billed Medicaid we don't attach the eob.  We indicate the allowed and paid amounts either on the electronic file, or on the paper Medicaid form.

Michele

[Sabrina]

Hi Michelle,

Thanks! for the info. I am paper filing to NC Medicaid since they did not crossover. I would have to send EOB. I have found out a way from Medicare to have claims crossover.

[Pay_My_Claims]

Sabrina, do you use the medicaid website, if so u can use that to submit the claim instead of sending it paper, even though it didn't cross over.

[Sabrina]

Hi Pay My bills,

I am aware of the NC Medicaid, I had a ton of claims to submit to secondary and it's time consuming if they do not crossover. Medicare did inform me how to submit a claim to crossover once billing Medicare, so I am in the testing phase to see if it actually works. Does your software system automatically cross over claims?

[Sabrina]

I meant to say Hi pay my claims,   lol

[Pay_My_Claims]

I meant to say Hi pay my claims,   lol

LOL@ pay my bills....
I currently still work in DME as I try to build my home based medical billing service. We use a system called TeamDME. We can submit electronically, but only do so for Medicare claims. Most of the high end rehab equipment we sell (wheelchairs) require documentation so they don't do electronic submissions. Our secondary's do cross from Medicare (but as you know not always). We use https://webclaims.ncmedicaid.com/ncecs/ to send Medicaid claims electronically. BCBS is now going to require all claims be submitted electronically, so we have now implemented an EMR system so that we can attach documentation to the claims we send. I have also used Misys and our system did set up for  crossover from comercial to caid, or commercial to commercial. We had it programmed for autocross from Medicare to 2ndary so it won't file a claim, and of course Prima was set to paper since they won't accept electronic claims. Are you only dealing with medicaid not crossing?

[Sabrina]

Hi Pay my claims,

I work full time in medical billing running the entire department in Mental health for group homes/Therapeutic Foster Care/Community Support/Diagnostic Assessment/Targeted Case Management.  I have billed for different speciality, DME among others. My part-time job is at home billing for LSCW. I do use the NC Web-tool . Where are you at in NC. I am in  NC myself.

[Sabrina]

con't

I bill for Medicare/Medicaid.

[Pay_My_Claims]

I am in Raleigh NC. You can email me if you want to give details about the system etc that you use. I don't know if I can help, but I will do what I can.