Wiki Medicare Billing for an ASC

[lisner1204]

I am having the most difficult time with my clearinghouse trying to setup billing for our new ASC. The commercial payers are fine. They are setup on UB-04s. From what I have read on CMS.gov, for an ASC Medicare and Medicaid claims need to be sent in a HCFA format. They problem I am having is this...Do I send them in a HCFA format with a professional payer ID or do I send them HCFA format with a UB payer ID or do I send them UB format with a UB payer ID. I have never billed for an ASC before, so this is all new to me and my implementation team is doesn't seem to know. They are putting it back on me to figure out what I want...Anyone have any suggestions?

Thanks,

Lori

 

[Walker22]

I used to bill for a Medicare ASC. If the ASC is a free standing facility, you send them in a HCFA format with a professional payer ID. If the ASC is affiliated with a hospital, you send UB format with a facility payer ID.

 

[lisner1204]

Thank you so much for the clarification! You don't know how helpful this is!