Medical Billing Forum
General Category => General Questions => : jpositos August 17, 2015, 11:58:23 PM
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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
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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
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Thank you.
Any recommendation on a user-friendly web-based software for UB-04 billing that will not break the bank?
Jocelyn
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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
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Thank you Michelle. I checked the link and price is good and this might work for the meantime.
Jocelyn
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I hope it works out for you. They have great support too.
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Hi Michelle,
Do you deal with anyone in particular at SpeedySoft? I called Sales and I keep on getting the voicemail to leave a message.
Does the UB04 software allow Print to File image so I can use a clearinghouse other than those they recommend?
Do they provide any codes (ICD9/ICD10, HCPCS, Rev) and if not, can I enter and save the codes I need?
Thank you.
Jocelyn
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I will send out an email to Dan and ask him for a number/person you can speak to.
I believe you have to enter your own codes, but you build up a database as you go.
I believe you can create an image and use your own clearinghouse, but I'm not sure. I will get back to you.
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I sent you a PM with a number to call.
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Hi Michelle,
Thank you!
I got your message, I called and got the answers I need!
Thank you again!
Jocelyn
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Hi Michelle,
It's me again. I read on previous posts by you and Alice about Xena web-based software that can do both CMS 1500 and UB04. Are they still in business and are you still using them? I can't seem to find their company web site online.
Thanks!
Jocelyn
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We actually lost touch with them several years back. I do not know if they are still in business or not.