JSwise
New
I recently took over billing accounts for a Provider, (Scenerio: Patient is established and has been seen for several years, we just found out that they had Medicare part B as Primary. In the past the office was billing the PPO insurance for services (which was/is actually the Secondary payer), and have received payment for services).
If a patient is being seen for Acupunture and Natropath services and has Medicare Part A and B as primary, and has a PPO as Secondary BUT the provider is NOT contracted with Medicare, (1) can the patient still be seen for these services? (2) Do you bill Medicare to obtain a Denial and then submit claims to Secondary? (3) Or do you submit claims directly to the secondary PPO bypassing Medicare all together since the provider is NON-PAR? (4) Should the patient be filling out a form or waiver, (ABN comes to mind but not sure), prior to services being rendered?
If a patient is being seen for Acupunture and Natropath services and has Medicare Part A and B as primary, and has a PPO as Secondary BUT the provider is NOT contracted with Medicare, (1) can the patient still be seen for these services? (2) Do you bill Medicare to obtain a Denial and then submit claims to Secondary? (3) Or do you submit claims directly to the secondary PPO bypassing Medicare all together since the provider is NON-PAR? (4) Should the patient be filling out a form or waiver, (ABN comes to mind but not sure), prior to services being rendered?