General Category > General Questions
medicare eligibility check
Philip:
I am actually was trying to check medicare eligibility for Homehealth(using DDE) when a patient choose to transfer their service to us and when they show that patient has another provider, how do I find out the details about that provider? Such as the facility name, contact and phone and fax numbers. Please advice.Thanks
PMRNC:
Not sure on DME ??? but when I dealt with other providers for clients that worked in nursing homes, we got a face sheet with all the referring physician information on it.
Pay_My_Claims:
--- Quote from: Philip on July 03, 2009, 10:52:23 AM ---I am actually was trying to check medicare eligibility for Homehealth(using DDE) when a patient choose to transfer their service to us and when they show that patient has another provider, how do I find out the details about that provider? Such as the facility name, contact and phone and fax numbers. Please advice.Thanks
--- End quote ---
We use the IVR for same or similar equipment (DME) (using HCPCS) codes. When it shows that information I call Medicare provider services and they will give me the date of service, the provider, and the phone number. They are supposed to now list snf, hospice on the IVR, and on their eligibility system, eventually list same or similar.
Philip:
Thanks a lot for your Reply. Now I got it . This is the first time I am using medicare DDE( Direct Data Entry) to check eligibility for Homehealth . I am new to billing.In Homehelath, we need to check th eligibility of patients before we admit them in our facility. Sometimes the patient will have HMO or PPO . When I check eligibility, , I was trying to figure out that also ( which HMO or PPO the patient has) . In this case also ,can I call medicare provider services to get the information of that HMO or PPO ? Please advise. Thanks in advance
Pay_My_Claims:
--- Quote from: Philip on July 03, 2009, 01:35:55 PM ---Thanks a lot for your Reply. Now I got it . This is the first time I am using medicare DDE( Direct Data Entry) to check eligibility for Homehealth . I am new to billing.In Homehelath, we need to check th eligibility of patients before we admit them in our facility. Sometimes the patient will have HMO or PPO . When I check eligibility, , I was trying to figure out that also ( which HMO or PPO the patient has) . In this case also ,can I call medicare provider services to get the information of that HMO or PPO ? Please advise. Thanks in advance
--- End quote ---
Yes, you can always call the IVR to obtain that information. It will give you the information about the HMO, PPO's and also other insurance primary. There are other eligibility portals to check medicare. Brightree is free for DME and HME provider, Passports(pay per usage), and the CSI/BE that is offered by Medicare (yearly fee, unlimited usage)
Good blessings to you
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