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weird Medicare denial?

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Christy:
ha ha Richard! Yes, we need to do whatever Medicare tells us to do, logical or not..... :-\

OK- so the issue was that the provider  (LCSW)was enrolled with Medicare as only able to refer/order services, but NOT provide services. She enrolled herself in 2012 and her claims were denied for 2 years and she never knew why until I figured this out.

So the problem was OUR fault, but Medicare gave me SO many different reasons for the denial. And I could not believe the rudeness of the claims reps- talking over me, yelling at me?!?! it was awful.

The provider line was so much better, the rep there fixed the problem and we were good to go within 24 hours.

So, the snafu was that Medicare expected 2 NPIs on the claims when they thought my provider was just ordering the services. But, she actually performed the services....hence, one NPI.

ugh!!!!!

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