General Category > General Questions

Biller - Medicare Registration/Enrollment

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PMRNC:
This is from 2008 but might be worth reading

http://corporate.findlaw.com/law-library/reassignment-rules-may-confuse-physician.html

shanbull:

--- Quote from: Michele on August 06, 2014, 10:57:30 AM ---You are speaking of Medicare specifically.  Medicare no longer sends paper checks (at least that's what they say).  I'm not sure if some areas are still sending them but I don't believe they will. 

--- End quote ---

The only circumstance under which they will issue paper checks is if an enrolled provider has not re-validated yet since March 25, 2011:


--- Quote ---Existing regulations at 42 CFR 424.510(e)(1)(2) require that at the time of enrollment, enrollment change request or revalidation, providers and suppliers that expect to receive payment from Medicare for services provided must also agree to receive Medicare payments through electronic funds transfer (EFT). Section 1104 of the Affordable Care Act (ACA) further expands Section 1862 (a) of the Social Security Act by mandating federal payments to providers and suppliers only by electronic means.
--- End quote ---
(from my MAC's EDI page)

New enrolling providers and providers who are revalidating for the first time since March 25, 2011 have no option besides EFT.

Scott:
Thanks for all the information.  It is very helpful and sounds like I don't want to be involved in receiving the funds.  My background is pharmacy billing for physicians where all funds come to me first.  So, it was what I was used to.  Thanks again.

Scott:
Linda, I read your link, which I found to be very helpful.  One thing that I picked up on is that if I wanted to be the agency receiving the funds, I could not charge the provider a percentage of collections.  Does the rule where I can't, as the billing agency, charge a percentage of collections apply if the money goes to the provider?  It's a little confusing to me as to how I can charge my clients for billing Medicare.

shanbull:

--- Quote from: Scott on August 06, 2014, 02:30:11 PM ---Linda, I read your link, which I found to be very helpful.  One thing that I picked up on is that if I wanted to be the agency receiving the funds, I could not charge the provider a percentage of collections.  Does the rule where I can't, as the billing agency, charge a percentage of collections apply if the money goes to the provider?  It's a little confusing to me as to how I can charge my clients for billing Medicare.

--- End quote ---

Not necessarily, it depends on your state's rules. Some states do not allow percentage billing, some do. The other option is to charge a flat fee, either per claim or time-based.

Medicare itself has not banned percentage billing when the money goes to the provider.

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