Chiropractic services are part of the standard Medical Benefits Package available to all eligible Veterans. All paper claims (HCFA-1500) should be mailed to: VHA Office of Community Care PO Box 30780 Tampa FL 33630-3780 … where they will be converted into EDI (electronic) format. VA claims can also be sent electronically. The payor ID for VA […]
Continue readingSuperbills are a mainstay of the cash practice. They contain information that the patient can use file their own insurance claims. A major problem with a superbill is that since they are simply a printout on plain paper which means that they could be reproduced and fraudulent claims then submitted by the patient. That’s why […]
Continue readingOption 2 on the ABN form [the Advanced Beneficiary Notice] should not be used as a way to circumvent the requirement to file the Medicare claim for the patient. Only in the event that a patient requests that you not file their Medicare claim, Option 2 on the ABN form can be used and the […]
Continue readingProviders have 30 days to update their enrollment information to reflect: A change in ownership An adverse legal action, or A change in practice location. Owners are individuals or corporations with a 5 percent or more ownership or controlling interest. Failure to comply could result in revocation of your Medicare billing privileges. Resources: Medicare: Vulnerabilities […]
Continue readingThe Medicare contractors have some leeway in the interpretation of the rules. Cahaba allowed chiropractors to modify the adjustment with AT & GA. However, it appears that Palmetto does not allow this. The AT modifier is used to indicate that the chiropractic adjustment is provided as an active/corrective treatment for an acute or chronic subluxation […]
Continue readingSequestration is a 2% reduction that is automatically withheld from Medicare payments. These reductions are borne by whoever payment is assigned to: The Doctor if he is participating because he must accept assignment The Doctor if he is non-participating and chooses to accept assignment The Patient if the non-participating doctor does not accept assignment The […]
Continue readingIf you are submitting paper claims (HCFA 1500) to Medicare you may receive a letter from you carrier stating “[regulations] require that all initial claims for reimbursement from Medicare be submitted electronically with limited exceptions.” One of the exceptions apply to small practices which is defined as one having fewer than 10 Full Time Employees […]
Continue readingThe Centers for Medicare and Medicaid Services (CMS) announced Nov. 2, 2017, that it will expand the low-volume threshold (LVT) that exempts some Medicare providers from having to report under the Merit-based Incentive Payment System (MIPS). For 2018, providers who treat 200 or fewer Medicare Part B beneficiaries or bill Medicare Part B for $90,000 or less […]
Continue readingJurisdiction J which was administered by Cahaba GBA has been taken over by Palmetto GBA. This affects chiropractors in Alabama, Georgia and Tennessee. If you are filing your claims electronically, your payer ID must be changed. The Palmetto electronic claim payer IDs are: 10112 (Alabama) 10212 (Georgia) 10312 (Tennessee) Mail claims to: Palmetto GBA Attn: […]
Continue readingAny HCFA 1500 paper claim form submitted for Medicare Part B that is not the current 02/12 version will be returned to the provider. You should be aware that there is at least one print vendor selling the outdated version 09/19 of the HCFA 1500 form. Our clients have always had good luck with this […]
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