Medical Billing Forum

Billing => Billing => : cflorez September 05, 2019, 09:03:49 PM

: Medicare suspension
: cflorez September 05, 2019, 09:03:49 PM
Has anyone every experienced a Medicare suspension. Is there anything we an do to obtain information on our suspension. They wont give us any information.
This third party audit company for Medicare is Adv Med. Can anyone help.
: Re: Medicare suspension
: kristin September 06, 2019, 01:17:28 AM
You need to contact your MAC directly. There are numerous reasons for a suspension/deactivation. Including failure to re-validate with Medicare, which is often the case.
: Re: Medicare suspension
: cflorez September 06, 2019, 03:46:07 PM
I called Medicare and with many transfers, they state there are no Mac reps. I would have to contact the person who pays the bills. That would be WPS, Indiana.
The administrator is the only one to check on that information. I am following up on that now. I will keep you informed of this.
: Re: Medicare suspension
: kristin September 09, 2019, 03:24:11 PM
Have you gone to the WPS website for Part B providers in Indiana (if that is who you are billing for), and there you will find the phone # to reach a live person. You will need NPI, Tax ID, and PTAN in order for them to help you. Also, you can always check the status of provider enrollment using PECOS, if you have the doctor/practice PECOS login info.
: Re: Medicare suspension
: cflorez September 09, 2019, 06:13:57 PM
Hello
Yes I have gone to WPS and that is where I spoke to several departments (customer service, provider enrollment, medical review and appeals to see if I can get a Medicare rep to speak to. An advocate for the Provider. That is where everyone told me there is no representative. Even provider enrollment states there is no representative. They all ask me to speak to the 3rd party review company. Which is Ad Med. I am looking for an advocate for the physician. Yes. Pecos is the area I am checking for if the provider need to be re-validated.  Has anyone experienced a suspension and can help me. Thank you
: Re: Medicare suspension
: Michele September 09, 2019, 08:17:18 PM
Sorry but I have not encountered this.  What did Ad Med say when you called them?
: Re: Medicare suspension
: cflorez September 10, 2019, 02:45:42 PM
Ad Med will not give myself or the Doctor any information. In their documentation to the Doctor they stated several lies and incorrect information. In which we have had copy proof, that this is not true. They are being very unprofessional and under handed. They have several lawsuits pending and they are putting practices out of business. That  is why I am looking for an advocate for the physician.
: Re: Medicare suspension
: PMRNC September 10, 2019, 07:05:20 PM
Skip the advocate and instead retain attorney, they will know what to do.