Medicare billing question
Answered
I feel like I'm stuck. I have a client who has Medicare primary (which I don't accept) and a plan I do accept for secondary. I am new to billing this way so it's taken me 3 months already and I feel like I'm stuck again. I did mail in my simple practice claim to Medicare because I was told I need a denial before submitting to her secondary insurance. I received a denial finally but it says that "The submitted cliam did not contain both sides of the form on a single sheet of paper." Does anyone use Simple Practice to submit to Medicare? Is there a way to print off both sides or do I have to order the CMS 1500 paper forms and complete them separately? Any suggestions on how to get the response I need would be greatly appreciated!
Thanks-
Kara
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Hi Kara, you can purchase blank CMS 1500 forms and then use them to print out the filled out form fields in SimplePractice. When you go to "Print" your claim, click the option to print with just the form fields and not the background. I've created a Help Request email on your behalf so a member of our team should be getting back to you to investigate this claim denial.
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HI Kara, I went through a 1490-S form which is a form that members can submit for Medicare to pay providers that are not contracted with Medicare. My client received a payment report that showed what Medicare paid and whey didn't. Now I am stuck when submitting the secondary claim because I don't know what to put in box 24 1c. I have the amount from the Summary Notice for how much Medicare allowed and paid but no code to enter into box 24, 1c. Have you submitted a secondary claim for this case yet?
Karli
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Hi Karli- The 1490-S form may be what I need. I've submitted the CMS 1500 form and they keep sending me back denials with errors that I need to change. This has taken months as each denial takes up to 6 weeks to receive. If I receive another denial I'll look into the 1490. Of course when I called I was not informed of this. It's just been a very frustrating process and I haven't even gotten to the secondary claim yet, which I'm sure will bring along it's own headaches. Good luck to you!
Kara
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Hi Karli and Kara, the only claim form in our system is the CMS 1500. If the insurance payer wishes to be billed using another form, you'll need to bill them outside of SimplePractice. Kara, I see my colleague James emailed you on October 30th confirming that you'd need to submit these sorts of claims outside of SimplePractice. I'd recommend reaching out to the insurance payer directly for advice on how to best bill them. You can often find the Provider Phone Number Line on the back of a client's insurance card, use this number to contact the insurance payer.
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Why doesn't SimplePractice simply create page 2 instructions of the CMS-1500 form so we can print the form as intended by CMS? Noridian won't accept forms w/o the instructions (which seems crazy). Trying to download a CMS sample...the side two doesn't print on a letter sized-page. I can work with this, but the logical thing is for SP to make this happen to save practitioners the headache of doing a work-around.
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Hi Kelly, I'll bring this up in our next Product Team meeting! In the meantime, please add it to our Ideas and Suggestions Board: http://simplepractice.uservoice.com/
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