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New provider billing


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#1 ugadawg

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Posted 09 January 2017 - 07:48 PM

Hi all,

 

I am a new graduate and will be starting work tomorrow. My office and I submitted my paperwork to become a medicare provider. I was wondering if anyone understands the laws and if I am allowed to see medicare patients or not. When I called medicare, they advised that I don't see medicare patients because if I get denied for some reason I would basically be seeing those patients for free. I asked about the "incident to" billing (found on AAPA website- you can bill under your supervising physician as long as you're just seeing a follow-up patient, and the medicare representative said they had never heard of this. Does anyone know if I can see medicare patients, or not? 

 

Thanks



#2 jmj11

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Posted 10 January 2017 - 02:56 AM

Hi all,

 

I am a new graduate and will be starting work tomorrow. My office and I submitted my paperwork to become a medicare provider. I was wondering if anyone understands the laws and if I am allowed to see medicare patients or not. When I called medicare, they advised that I don't see medicare patients because if I get denied for some reason I would basically be seeing those patients for free. I asked about the "incident to" billing (found on AAPA website- you can bill under your supervising physician as long as you're just seeing a follow-up patient, and the medicare representative said they had never heard of this. Does anyone know if I can see medicare patients, or not? 

 

Thanks

You must have an NPI number and enrolled with Medicare ( see here ). When enrolled, you can bill independently or incident to, per the protocol for each way. If you are not enrolled, and you see a medicare patient, you will be seeing them for free and it does not matter if it is independent or incident to. It is the responsibility of the practice to enroll you so that you get paid for your services. I would be a millionaire today if I had been paid for all the patients I have seen for free over the years for one reason or the other.


JMJ

#3 ugadawg

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Posted 13 January 2017 - 04:23 AM

Haha! Thank you for the reply. We have applied for my enrollment in medicare. We were just unsure if I could see patients while we are waiting for the paperwork to go through.



#4 jmj11

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Posted 15 January 2017 - 03:42 PM

Haha! Thank you for the reply. We have applied for my enrollment in medicare. We were just unsure if I could see patients while we are waiting for the paperwork to go through.

Medicare will not pay a penny on claims they receive before you are enrolled. Even if you SP is enrolled and in good standing, no payments will be made on patients that you see.  Good luck.  


JMJ

#5 EvanBurke

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Posted 23 May 2017 - 09:32 AM

I'm interested is there any options in medicare to payments in case SP is enrolled. 



#6 jmj11

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Posted 24 May 2017 - 05:01 PM

sorry, posted in the wrong place.


JMJ

#7 dizzyjon

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Posted 24 May 2017 - 06:09 PM

Last I recall there was a 30 day retroactive billing period.  So, if you get credentialed June 1st, you could submit claims to be paid for 30 days prior to your enrollment date.  This may have changed, but something you could look into. 


PA Jonathan, DHSc

EM/hospitalist/psych/Doctor of Health Science





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