I set him up with Novitas Texas as an added user under my submitter ID. I get the approval that he is added on 6/21/14, submit the 25 "test" claims in order to go into live production. I call on this past Friday and I'm notified that the physician cant be set up under my submitter ID because I am not billing "live". Per the Novitas rep since I am using a software that uses Office Ally as their clearinghouse, I should have added the provider to the clearinghouse submitter ID.
You don't setup new clients under your submitter ID.
1. I'm thinking the only reason a biller would have a Submitter ID is because that biller is submitting directly to Medicare, electronically??
Any biller who submits directly to Medicare can submit claims for new clients under their Submitter ID, provided they do what Medicare requires for billers who are submitting directly??
I rebilled his claims from the end of March that rejected for claim form and the new billing from April on paper using the CMS 1500 version 02/12. The claims came back rejected again for missing the back page. I have a program that is form fillable to the red HCFA form, I bill Medicaid without the back form and sent the claims to Medicare without the back page of the CMS in error. Once I received the rejection I re-mailed the claims ((this time with the back)). The re-mail was done on 6-11-14 and as of this past Friday the claims are still not on file. I have the DR I am billing for in box 17, a DN Qualifier in 17a and the doctors NPI in 17b. In box 21 I also have the ICD indicator marked. Also, the NPI is populated appropriately in 24J, 33A and 32A. What could be causing the rejections for the paper claims ?
He and I agreed to send the paper claims while I set him up electronically, well that's another problem. I set him up with Novitas Texas as an added user under my submitter ID. I get the approval that he is added on 6/21/14, submit the 25 "test" claims in order to go into live production. I call on this past Friday and I'm notified that the physician cant be set up under my submitter ID because I am not billing "live". Per the Novitas rep since I am using a software that uses Office Ally as their clearinghouse, I should have added the provider to the clearinghouse submitter ID.
My software vendor emailed me today stating ALL the claims I have submitted electronically for Medicare came back rejected due to NPI/Tax ID mismatch to the EDI clearinghouse/submitter ID. I am refaxing the paperwork tomorrow morning first thing linking the provider to the Office Ally clearinghouse submitter ID. But the doctor is pissed to say the least. His commercial claims are going over fine, but he wants the Medicare check like last month. He stated he can't have it held up any longer. I am thinking of emailing him and waiving his July payment. But I feel like there's nothing but excuses on my part. I truly didn't know he had to be on the clearinghouses submitter, and for the life of me I cant figure out what to do about the paper claims. So ready to quit :-( I feel so down about this
Does any possibly know what could be wrong with the paper claims? Is waiving the pay a good idea since he hasn't received Medicare payment in the 3 months I've been on board?