Wiki Billing Medicare under PPS

Create Wiki
T

tamil_u

New
Messages
6
Location
Bangor, ME
Best answers
0
I work for an FQHC and we are now billing under the new PPS. The G codes we are required to use with every E/M service haven't been much of a problem for us in regards to getting our Medicare claims paid. However the Medicare supplement plans keep denying stating that they either don't pay that code or that the amount allowed is inflated (which of course is what Medicare requires therefore the EOB's confuse the supplemental plans). Is anyone else having this issue? I've tried sending letters to explain but am not getting anywhere.
 
supplemental

We are not having any issue with our secondary payors paying. The only one that i am aware of that is having a little bit of an issue is POMCO. We are from NY not sure if you bill to them or not..

I do however have a question for you.. We are a primary care and we do incision, wart removals, blood draws, ear wax removals, A1c, and allergy shots. Are you getting paid for these services? if you are not than you havin the patient sign an ABN waiver what policies do you have in place for these services?
 
You must log in or register to reply here.
Top