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Billing Medicare and Medicaid

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DavidZ:
As a billing company do you have to have authorized to bill medicare/medicaid?
If yes, what is the process?

How do you enroll a provider in PartB Medicare, what is the process and how long does it usually take?

PMRNC:
A billing company does not need to be enrolled, but they should be listed on the enrollment as the billing agent.

A provider can enroll now online using the PECOS http://www.cms.hhs.gov/MedicareProviderSupEnroll/

Michele:
The process to enroll a provider in Medicare varies depending on the carrier.  I have some go thru in as little as 4 weeks, but most are anywhere from 6 wks to 12 wks.

Michele

DavidZ:
Thank you guys,
The cases here are: there is that a provider that has medicare/medicaid patients and a inhouse biller that they want to replace by outsourcing to us. The question was posed to us: how long will it take for you to take over and start billing.(medicare/medicaid included)
What do you do in this case, when the client wants you to take over ASAP.
Given that there will be a delay of about 3-4 weeks, how do you present that and still get the client?

Also what happens if the provider that you are trying to get has been enrolled in medicare for a couple years and would like to switch billing companies. What is the process here and how long should it take?

PMRNC:
There is always a slight delay when there is a change such as going outsourced. The Medicare Enrollment applications have a spot where the new billing agent is listed. In addition you have to connect that enrollment to your clearinghouse, the delay is simply because you can't have two submission processes (2 clearinghouses, ..etc)
The average time for such a change is only about 2 weeks. NEW enrollments (doctors NOT enrolled previously) are a bit longer. The claims can still be entered but what I do is put them in "hold" status until we are ready to roll.

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