Advanced Search

Medicare Compliance & Reimbursement

BILLING:

Give Your MAC Permission To Communicate With Billing Company

Published on Sun Oct 25, 2009

Prepare ahead of time by designating the billing company on your enrollment form. Health Insurance Portability and Accountability Act (HIPAA) laws were created to prevent your patients' protected health information (PHI) from getting into the wrong hands, but at times, the privacy laws may throw a wrench into your relationship with your billing company. The scenario: You receive a denial from your Medicare Administrative Contractor (MAC) but you are unclear about the service code on the Explanation of Benefits (EOB). You ask your billing company to get to the bottom of the denial, and their representative phones the carrier. However, the MAC refuses to speak with your billing company rep, citing HIPAA laws that prevent them from discussing your patients' private information with an outside entity. First idea: Your billing rep might offer to send the MAC a copy of your business associate agreement, but not all MACs will let [...]
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Medicare Compliance & Reimbursement

View All