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Medicare Billing

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Our agency just became In Network with Medicare.  I have been looking for a free portal to submit Medicare claims.  We are currently using the following portals to submit claims Optum for UHC, Emdeon for AmeriHealth, Availity for Amerigroup, PC Ace for straight Medicaid and then Blue Cross Blue Shield has their own.

Each of these portals are free to submit claims.  I am looking for the same for Medicare.  I have spoken with each of these and to include Medicare, we would have to increase to Premium Memberships.

We are a small agency with one Mental Health Counselor and one Substance Abuse Counselor and 3 clients that have Medicare.

Are there any free portals out there to submit claims?

Thank you.

I believe you use PC-ACE Pro 32 to submit Medicare claims.  It has been many years since I have used it but that is how it used to be done.

Have you looked at Office Ally? They process claims for hundreds of commercial insurances as well as Medicare (not sure about Medicaid.) I find it so convenient, not to have to log in to multiple websites, although I do use Optum for UBH and United Healthcare just because it's such a user-friendly website. If your government claims are under a certain percentage of your overall claim submissions in any given month, Office Ally is free.

Also re: Office Ally, I've had two client/providers who only needed to bill Medicare. The rest of their practice is cash pay (psych.) Each provider saw between 9 and 12 Medicare pts. monthly. If you can keep to 10 or fewer government (Medicare/Medicaid, etc.) patient billings per month, they waive their monthly fee (usually $19.95, I think.)

These two clients were very cooperative and if they saw more than 10 clients in a month, they were fine with me just carrying over the charges to the next month. So for example, they had a pt. they saw once or twice in a month, I'd hold off and bill those dates with the following month. There's no limit on the number of days per claim.

I am not affiliated with Office Ally, I just like using their website. (I don't bother with their Practice Mate.)

Wow, I love Office Ally and have used them for years.  Not a fan of Practice Mate.  But I didn't realize you could enter claims right into OA?

Thank you for the information so far.  I am looking into Office Ally currently.

There is a part however that states:

* If my Government/Non-Par (G/NP) claim volume is greater than or equal to 50% of my total claim volume in a month, my account is subject to a processing fee of $19.95 for that month*.
* If my Government/Non-Par (G/NP) claim volume is less than 50% in a month, I will not be charged this fee for that month.
My plan would be to use Office Ally to submit Medicare.  Right now we only have 4 clients that maybe come 1 time per week.  So 100% of my claim volume would be G/NP.

Am I right in my conclusion?


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