Small Medicare Providers Submitting Paper Claims for PT, OT, SLP
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- čas přidán 18. 08. 2019
- #physicaltherapymedicare #occupationaltherapymedicare #speechtherapymedicare
Buy CMS 1500 - amzn.to/2KBpMcE
Here is content from CGS Website: Submitting Paper Claims
The Administrative Simplification Compliance Act (ASCA) requires that as of October 16, 2003, all initial Medicare claims be submitted electronically, except in limited situations. Medicare is prohibited from payment of claims submitted on a paper claim form that do not meet the limited exception criteria.
CMS has provided a listing of exceptions to electronic claim submission on its Administrative Simplification Compliance Act Self-AssessmentExternal Website Web page. Some of these include:
Small provider claims
Claims from providers that submit fewer than 10 claims per month on average during a calendar year
Claims for payment under a Medicare demonstration project that specifies paper submission
In addition, CGS has identified the following situations where it may be necessary for home health and hospice providers to submit paper claims:
Claims for dates of service that exceed Medicare timely filing guidelines
Claims that have been denied by the Federal Black Lung program and the provider is requesting Medicare payment. Refer to the Submitting Medicare Secondary payer (MSP) Claims and Adjustments Web page for additional information.
Prior to submitting any paper claims to CGS, home health and hospice agencies should conduct a self-assessment to determine if they meet one of the exceptions for electronic claim submission by accessing the CMS Administrative Simplification Compliance Act Self-AssessmentExternal Website Web page.
When appropriate, paper claims should be mailed to:
J15 - HHH Claims
CGS Administrators, LLC
PO Box 20019
Nashville, TN 37202
Here is the reference for Noridian: med.noridianmedicare.com/web/...
Here is the reference for Palmetto GBA: www.palmettogba.com/palmetto/...
Here is the CMS Reference: www.cms.gov/Regulations-and-G...
Let's look at the math behind paper claims.
1.) Buying paper claims and printing costs...
2.) Time at computer printing, packaging, mailing...
3.) Cost of mailing supplies and postage...
4.) Possible lost time in the mail not being delivered...
If you were to mail once a week you could save on time and packing supplies, but submitting electronically would allow you to submit daily. This allows you to catch problems faster.
✔️ If you would like to learn more about Medicare billing please join our FREE Facebook community at / mcrbilling
✔️ If you are interested in learning more about billing Medicare check-out our website at www.learnmedicarebilling.com
✔️ And if you just want to learn more about me 😀 check-out my Facebook profile at / anthony.maritato.73
If you would like to mail me:
Total Therapy Solutions
5900 Long Meadow Dr
Middletown, OH 45005
thank you SOOOO much for this. as a new doctor, this is so helpful, as i am so lost right now.
Glad it was helpful!
hi dad ,great video can't talk much BYE!!
Great information!! I have a question. Do you provide medicaid billing training?
I need to know what printer to use for printing out claims to line up using the 1500 or UB
VERY NEW HERE TO A PRIVATE PRACTICE: HOW DO I WRITE THE DIAGNOSIS CODE FOR F80.2? WITH OR WITHOUT THE . ?
helpful....thanks. Did you find out if one can submit paper but have EDI w/out a fee?
I didn't get an answer I was convinced of. Maybe you could call your MAC and ask "Can I submit paper claims but still receive ERA remits?" If you ask let me know what answer you get.
So you if we're not currently taking any insurances outside of Medicare and we are giving a client a Superbill to submit for reimbursement, we can just fill out a paper official CMS 1500 form as the Superbill? If I have my own Superbill (2 templates actually, 1 from ASHA for SLP), will using CMS 1500 really ensure reimbursement likelihood? Thanks!
Kim Schaefer it will give your client the best chance.
Being new to the paper forms, I inadvertently bought the 2-part snap outs. Can I use each sheet on its own? They look identical though the one on the bottom is thinner. That's the only difference. Also, is white-out a no-no?
Definitely no White-out!
As for the forms, I don't know. If they look the same then give it a shot.
how do I become in network provider or do I need to with only 2 employees and me self
Would this be something for NEMT services, especially billing private sectors and other Medicare insurance.
Yes, it should.
I run a billing company pleas lete know of billing issues
How to add text and not print the red parts of the document in black and white
I have questions about billing for mobile phlebotomy. Is there a email address were I can contact directly? Thanks! Great video!
Brandi Yancey I wish I could help but I don’t know anything about that. I only deal with PT/OT/SLP
You can reach me at tony@totaltherapysolutions.com
Hi, do you have any information on how to start this Mobile PT in Florida? Thanks
Ariel Abella are you in our Facebook group? I originally started in Florida then moved to Ohio. We have lots of FL clinicians in our group.
I am also starting a new cohort in my Medicare billing course on February 4th.
Www.learnmedicarebilling.com
The Facebook group is free and has lots of info.
facebook.com/groups/mcrbilling/?ref=share
I graduated from FIU and lived in Sarasota.
Thank you for your promt response. I used to own a private practice in st. Augustine but owning a private practice takes a lot of your time. So I decided to sell my practice and work part time. But here in Jax. It’s so hard to find a part time job. If there’s part time job opening. Hospitals and other companies would prefer new grad vs to someone like me with more than 20 years of experience. I guess less pay for new grad PT. Anyway, I thought before that Medicare stopped approving home based Med B practice. It needs to have a physical location. So I guess based from your response home based PT or mobile PT could still be done. I will sign up in your FB page. Thanks again
I was to start a physical therapy house call (med part b) program in my area targeting geriatric population. I have liability insurance, individual npinumber. What other requirements do I need in order to see Medicare patients? What paper based PT doc system or EMR do you recommend?
Do you have your Medicare provider number? (PTAN) Are you in our Facebook Group?
@@LearnMedicareBilling thank you for the valuable info. How do I get PTAN? I will search for your Facebook group.
@@gokartikgo The PECOS website is where you would apply for your Medicare number.
pecos.cms.hhs.gov/pecos/login.do#headingLv1
@@gokartikgo The facebook group is facebook.com/groups/mcrbilling/