General Category > General Questions
DME billing
Pay_My_Claims:
--- Quote from: margemib on July 04, 2009, 01:29:17 PM ---do you charge a different rate depending on what the supplier wants you to do?
margemib
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Girl yes!!! For instance, you have to depend on the physicians to supply you the information required to submit to Medicare for ADMC approval (except with dx of ALS), and some providers you have to pull teeth to get it done. You only have 45 days from the date of the face to face to have everything stamped and submitted or the client has to do it again.
margemib:
with all the info you need I guess you cannot fill this electronically, or can you?
Buy the way I checked out your website, I like it very much it's very professional.
margemib
Pay_My_Claims:
--- Quote from: margemib on July 04, 2009, 05:21:25 PM ---with all the info you need I guess you cannot fill this electronically, or can you?
Buy the way I checked out your website, I like it very much it's very professional.
margemib
--- End quote ---
Yes, you can still file electronically!!! The documentation (Medicare) has to stay on file for 7 years. (but you still must follow your state & federal guidelines for document retention). Once you get ADMC, you just basically submit the claim because they have reviewed the documentation. BCBS is one of the pain insurance companies that will request additional information (Your cost) especially on the K0108 (misc) or the e1399n (unlisted) codes. NC work comp does the same. they only pay 20% over cost (not MSRP) when there is a code not listed on the comp fee schedule. Because I know what they(BCBS) will send back for medical records request (our cost), I will split a claim. I will file electronically what is on the BCBS fee schedule, and the unlisted codes, I will send paper along with our invoice. This way the entire claim isn't held up for documentation. I know the Medicare PFFS plans will request an LMN, so I simply submit them by paper. I can still as stated file electronic, and have them send a request for the LMN and the guarantees the claim is already loaded into the payer system. Also BCBS has the electronic fax back system so the fax is directed back to the requesting person and it helps to expedite things. Yes DME is somewhat slower in some areas, but in others, its just as quick. I have the most difficulty with Medicare (waiting on documentation), the replacements, and BCBS since we are non-par. Most once you get authorization, you are done. Most of the PFFS plans don't require auth, so they will need a LMN or CMN.
Thanks on the compliment on the website.
margemib:
WOW you really know your stuff!
Thanks for all the info, it is very interesting.
Have a good rest of your weekend!
margemib :o
Pay_My_Claims:
--- Quote from: margemib on July 04, 2009, 08:40:32 PM ---WOW you really know your stuff!
Thanks for all the info, it is very interesting.
Have a good rest of your weekend!
margemib :o
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You are more than welcome..I really love what I do!!!
Enjoy your holiday as well ;D
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