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forms for medical biller

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best biller:
I am in NY.

Thanks

clarissia:
Hi I'm in tx and I also wanted to know what forms needs to be filled out to let the insurance companies known will be taking over the provider billing...with medicare will I just need to complete the 855i and 855r..

Billergirlnyc:
 NY requires third party billing companies to register as "service bureaus" if they're submitting on behalf of a medicaid provider. There is a vetting process as in they want info on you, your company, and they require to know how you will charge your client to either just submit claims or prepare and submit claims on their behalf. It can't involve fee splitting they need to ensure you're following compliance, etc.  ---> Link to forms you need in NY and instructions, etc https://www.emedny.org/info/ProviderEnrollment/svcbur/index.aspx


--- Quote from: clarissia on February 08, 2013, 01:52:29 AM ---Hi I'm in tx and I also wanted to know what forms needs to be filled out to let the insurance companies known will be taking over the provider billing...with medicare will I just need to complete the 855i and 855r..

--- End quote ---

I would call the Texas Medicaid office to see if there are any requirements for billing companies in Texas, if you don't get an answer here.

As far as Medicare, if a provider/doctor/hospital, etc is using a billing service they're required to inform Medicare on either the 855I (physicians/non-physicians), 855B (clinics/group practices, etc), or 855A (institutions/hospitals).  The 855R serves an entirely different purpose and is strictly for reassignment of benefits or terminating reassignment, so you wouldn't use it to let Medicare know about a billing service.

As far as I know only Medicare and Medicaid have these types of requirements, but again, with Medicaid it's on a state-by-state basis, thus your need to do a bit of research in your state or the states you'll be working in. Medicare is pretty clear no matter what state you're in, because their forms are universal.

Also, those Medicare forms can't be signed by you. I'm sure you know this, but throwing it out there for those who don't. They're signed by either the authorized official(s) or delegated, etc.

clarissia:
Thanks, you've helped me a lot

Billergirlnyc:

--- Quote from: clarissia on February 11, 2013, 12:43:11 AM ---Thanks, you've helped me a lot

--- End quote ---

You're very welcome and glad I could help.  :)

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