Mirena!

kinzua23

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Anyone have any tips for billing Mirena?? My doc has been trying to have patients self pay due to the fact that they cost so much and we are only getting reimbursed for 1/2 the cost, so we are actually losing money! Is anyone else having this problem?


Any input would be helpful!!
 

Kris Cuddy

Guru
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We get reimbursed a little bit above the cost, plus for the insertion. If you describe how the billing's being done when these are being inserted, I may be able to offer some assistance.

Kris
 

mlk

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Mirena

My office files and it depends what insurance company you file. We have a lot of medicaid pt. The company will supply the medicaid pt and we file only the insertion of device. What dx you use for filing? We use V25.1. You can email me at shellie34@newwavecomm.net if you have any questions.
 

tpkeith

Networker
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44
Location
Chattanooga, TN
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We are reimbursed a little more than our costs for the device. We are also paid the insertion fee. You are billing the insertion fee plus the HCPCS code for the device? We have worked with our payors to negotiate cost of the device.
 
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We bill J7302 for the device and 58300 for the insertion. Essentially you make very little on the device.
 

dmaec

True Blue
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Duluth, Minnesota
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we bill J7302 & 58300 also/ and small reimbursement - I don't believe you can make a patient pay for something that is billable to their insurance because the insurance doesn't reimburse very much. Apparently, that's all worked out with the contract deals they agree upon during negotiations to be "in-network" providers and accept payment from the insurance company. If facilities/providers want more reimbursement on the mirena, they'll have to keep that in mind at next negotiations! otherwise it appears to be pretty much a wash for all involved!
 

hswift

Contributor
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We also use J7302 and 58300. We verify each patient's coverage before insertion. If it is not a covered service the patient must pre-pay the device and or insertion. This is an elective service, if the insurance plan does not cover the cost, I don't think you have to provide the service.Mirena has a website for providers and will verify coverage of the deivce by medical insurance and the perscirption plan - sometimes the RX plan covers the device and Mirena will bill and ship to you, then you just charge for the insertion. Ask your rep to help you get set up or go to the Mirena web site. We also order five at a time. If you pay within 90 days, you receive a discount. This helps offset the low reimbursement, especially with Welfare patients. Hope this helps
 
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