rsrizzo
Guest
- Messages
- 8
- Location
- NJ Monmouth Ocean
We are a practice that is par with Medicare [MCR], but is non-par with NHIC (Medicare's DME provider).
We have been unable to submit claims for Custom Orthotics (L3000) 'thru' NHIC in order to get their processed denial due to non-covered service. All of our patient's have a secondary carrier that covers custom orthotics but must be denied by MCR first. We have attempted without success to have the patients submit a MCR claim using the CMS-1490S form but then the denial to the patient states that the claim must be sent by the physician who must be a NHIC participating physician.
To become par to NHIC costs > $300.00 and must be activated atleast once/quarter. Without keeping active, a reactivation fee of the same initial fee of > $300.00 is charged again. We do not always make custom orthotics every quarter.
Please help. We have NO answer. This is not fair to our long term patients who need custom orthotics and have Medicare insurance which 'should' process their claims.
Thanks,
rrbillr
We have been unable to submit claims for Custom Orthotics (L3000) 'thru' NHIC in order to get their processed denial due to non-covered service. All of our patient's have a secondary carrier that covers custom orthotics but must be denied by MCR first. We have attempted without success to have the patients submit a MCR claim using the CMS-1490S form but then the denial to the patient states that the claim must be sent by the physician who must be a NHIC participating physician.
To become par to NHIC costs > $300.00 and must be activated atleast once/quarter. Without keeping active, a reactivation fee of the same initial fee of > $300.00 is charged again. We do not always make custom orthotics every quarter.
Please help. We have NO answer. This is not fair to our long term patients who need custom orthotics and have Medicare insurance which 'should' process their claims.
Thanks,
rrbillr