Medical Billing Forum
General Category => General Questions => : best biller February 05, 2013, 08:22:59 PM
-
Is there any forms a biller is supposed to complete with any of the insurances when starting to bill for doctors?
-
I provide my clients with a matrix which allows them to enter the information for each carrier they par with. I also require a copy of the payment fee schedule and contract as well. Not sure if that is what you were asking about our not.
-
Or do you mean when you're calling them to verify benefits? Or do you mean do you have to let them know you're billing on behalf a new client? Just be a bit more specific and we can help you, thanks.
-
if i have to let them know that im billing on behalf a new client?
-
You have to check with your state in regards to Medicaid, Some states do require registration for billing Medicaid, but Medicare providers have to report a change or addition of a billing agent.
http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/MedicareProviderSupEnroll/index.html?redirect=/medicareprovidersupenroll
-
I am in NY.
Thanks
-
Hi I'm in tx and I also wanted to know what forms needs to be filled out to let the insurance companies known will be taking over the provider billing...with medicare will I just need to complete the 855i and 855r..
-
NY requires third party billing companies to register as "service bureaus" if they're submitting on behalf of a medicaid provider. There is a vetting process as in they want info on you, your company, and they require to know how you will charge your client to either just submit claims or prepare and submit claims on their behalf. It can't involve fee splitting they need to ensure you're following compliance, etc. ---> Link to forms you need in NY and instructions, etc https://www.emedny.org/info/ProviderEnrollment/svcbur/index.aspx (https://www.emedny.org/info/ProviderEnrollment/svcbur/index.aspx)
Hi I'm in tx and I also wanted to know what forms needs to be filled out to let the insurance companies known will be taking over the provider billing...with medicare will I just need to complete the 855i and 855r..
I would call the Texas Medicaid office to see if there are any requirements for billing companies in Texas, if you don't get an answer here.
As far as Medicare, if a provider/doctor/hospital, etc is using a billing service they're required to inform Medicare on either the 855I (physicians/non-physicians), 855B (clinics/group practices, etc), or 855A (institutions/hospitals). The 855R serves an entirely different purpose and is strictly for reassignment of benefits or terminating reassignment, so you wouldn't use it to let Medicare know about a billing service.
As far as I know only Medicare and Medicaid have these types of requirements, but again, with Medicaid it's on a state-by-state basis, thus your need to do a bit of research in your state or the states you'll be working in. Medicare is pretty clear no matter what state you're in, because their forms are universal.
Also, those Medicare forms can't be signed by you. I'm sure you know this, but throwing it out there for those who don't. They're signed by either the authorized official(s) or delegated, etc.
-
Thanks, you've helped me a lot
-
Thanks, you've helped me a lot
You're very welcome and glad I could help. :)
-
Hello everyone I am a student and I'm about to graduate yet, I am having a very hard time with Advance Coding. Please can anyone help me.
-
Hello everyone I am a student and I'm about to graduate yet, I am having a very hard time with Advance Coding. Please can anyone help me.
What kind of help you need exactly?