tci Medicare Compliance & Reimbursement - 2012 Issue 10

Reader Question: How Should You Bill Medicare?

Question: We are participating with Medicare. We bill and submit claims to Trailblazer (J4 MAC). When payment arrives, we post the allowable and contractually adjust off the remaining portion and/or apply the appropriate amount to the patient deductible per the CMS remit. However, my predecessor was billing only the Medicare allowable for each code? Am I doing it right? Or was she? Answer: Both methods are technically correct. Practices bill Medicare in two different ways: 1. Some practices bill Medicare at the Medicare fee schedule. That sounds like how your predecessor was doing things, by billing the Medicare allowable...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.

Thank you for choosing Find-A-Code, please Sign In to remove ads.