General Category > General Questions

In-home Hemodialysis Billing

(1/3) > >>

jpositos:
Do we have an expert in home hemodialysis billing in this Group?  I need help to correctly bill for a home health company who does hemodialysis at patients home and they are out-of-network; commercial insurance only and do not bill Medicare.  Contracted Nurses do the dialysis at patients home. Do I bill with CMS 1500 or UB04? 

Thank you.

Jocelyn

RichardP:
In terms of Medicare, Home Health Agencies are considered Institutional Providers.  As such, they are required to use the UB04.  If the Home Health Agency is approved as a DME supplier, they would submit claims for DMEPOS services on the CMS-1500 Form. 

Each Private Insurance Carrier likely has its own standard.  It may mirror the Medicare standard, or it may not.  You won't know until you ask them.

See Page 5 of this link:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c10.pdf

That link came from here:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/837I-FormCMS-1450-ICN006926.pdf

jpositos:
Thank you.

Any recommendation on a user-friendly web-based software for UB-04 billing that will not break the bank?

Jocelyn

Michele:
Jocelyn,

We use Speedysoft for our UB04 claims.  We have used them for years.  It is very reasonable (I think about $250 - $275).  It has electronic capabilities.  Doesn't have a ton of bells and whistles but it works for our needs.  In all fairness, we have not worked with any other UB04 software.  You can read more at:

http://www.speedysoftusa.com/shop/affiliate.php?id=2&redirect=http://www.speedysoftusa.com/speedyclaims.html 

Disclaimer:  We are an affiliate of Speedy Soft

jpositos:
Thank you Michelle.  I checked the link and price is good and this might work for the meantime.

Jocelyn

Navigation

[0] Message Index

[#] Next page