Medical Billing Forum

Billing => Billing => : gbratcliff March 19, 2012, 12:01:48 AM

: Medicare denials
: gbratcliff March 19, 2012, 12:01:48 AM
Has anyone had any issues with Medicare processing claims?  For months now I have been
getting denials for missing/incorrect information and everytime I call I'm told something
different to add or delete or change on my HCFA . I'm so frustrated right now !! I am in
South Carolina and could use some suggestions or ideas or what I should do ! Thanks !

Gina
: Re: Medicare denials
: Michele March 19, 2012, 08:59:25 AM
It sounds like you just don't have all of the required info in the correct spots.  In order to help we would need more info on the specific denials.
: Re: Medicare denials
: PMRNC March 19, 2012, 01:12:03 PM
Specific rejection/codes would help. Are these rejections related to the HIPAA 5010 submission?
: Re: Medicare denials
: rkillian April 01, 2012, 09:45:10 PM
We have had the same problem since the first of the year.  We are in Michigan.  I was first told it had something to do with a 5010 update, then I was told we were missing the rendering provider (but we were not), then I was told to just rebill it because they didn't know.  I am working with our vendor and clearinghouse because I am stuck with no answer.
: Re: Medicare denials
: Michele April 02, 2012, 09:31:59 AM
Hopefully they will get to the bottom of it quickly!
: Re: Medicare denials
: PMRNC April 02, 2012, 09:33:55 AM
From what I have read and understand, any 5010 rejections given are usually at the clearinghouse level. There have been some clearinghouses who were not ready.   ::) :o
: Re: Medicare denials
: macbook April 03, 2012, 11:39:24 PM
I use Centircity and I have the same 5010 issues. Although I go thru the clearinghouse, to get my rejections, but I work closely with our vendor support to help me thru the 5010 rejections. So far we have been ok. Sometimes, they just need to tweak the system here and there.