Wiki online Medicare claim submission

Community Wiki

This is a community-maintained wiki post containing the most important information from this thread. You may edit the Wiki once you have been on AAPC for 30 days and have made 5 posts. Learn More
M
Good evening, I have a quick question regarding billing Medicare for CPT code 78815 and HCPCS code A9597, Medicare has denied 78815. Not sure why, has anyone else had this issue? No prior authorization is required per CMS. Any advice would be appreciated.

cfukuda

New
Messages
3
Location
Honolulu, HI
Best answers
0
I am a new claim submitter (CPC-A) for a solo psychotherapist in CA and totally new to submitting Medicare claims online (have finished EDISS registration). Which software would you recommend, ABILITY or Medicare Remit Easy Print? Do they have a printing function to send a bill to a patient after getting an EoB? If not, how do I send a bill to him/her? Any advice would be most appreciated.
 

SharonCollachi

True Blue
Messages
1,970
Location
Clovis, CA
Best answers
3
We submit through Availity, using our own software (Meditab). You can print EOBs out of Availity or download them to your computer. As far as sending a bill to the patient, that will come out of your own software after you post the payment and adjustments.
 

cfukuda

New
Messages
3
Location
Honolulu, HI
Best answers
0
Thank you very much for your reply. So that means we can submit medicare claims through Availity? (i.e. No need to have ABILITY+their networking vendor?). If you don't mind, could you tell me how much Availity costs you per month?
 

SharonCollachi

True Blue
Messages
1,970
Location
Clovis, CA
Best answers
3
I don't know what Ability is. We use our practice management/billing software, Meditab, to make a file that is then uploaded, thru Meditab, to Availity. The EOBs are downloaded into Meditab when payments are made to us. Availity has a lot of different options on how to get them the information, so I would reach out to them for more information.

Our previous practice management software, Kareo (boo, hiss!), also created a file that was uploaded to several different clearinghouses, and electronic EOBs were downloaded into Kareo.

Our pricing is confidential, but we only have one provider, and I'm the epitome of cheap.
 
Top