Results 1 to 2 of 2

DME billing BCBS

  1. #1
    Upper Saddle River, NJ
    Default DME billing BCBS
    Medical Coding Books
    We are having difficulty getting paid for durable medical equipment (DME) when our provider needs to ship the product to a patient out of our local area.

    When we submit to the local Blue Card office they deny and say it needs to be submitted to the Member's Home Plan. When we do submit to the Home Plan the claim is denied stating must be submitted to the local Blue Card plan.

    Is anyone having any success with this scenario?

    Thank you
    Sharon Clarke, CPC
    Billing Associate

  2. Default out of area
    We are DME here too, and we have run across several issues about out of area insurances. Humana for instance will successfully send to the correct jurisdiction if we submit wrong or patient hasn't changed address with them. Medicare will send it back to us, etc. What we find is that when we change the address at the insurance level on the patient in our software it will be sent to the correct payor(and their jurisdiction). Now,, some things we won't cover anymore if the patient left our area because the reimbursement changes and it won't be worth it. What I would do with the bcbs is use whatever the patients address is on file with Them use that,, not what the delivery address is,,,it may be two separate addresses. It should file to correct BCBS. However, without really looking at all the stuff in front of me, its easier said than done. Good Luck!

Similar Threads

  1. BCBS of GA billing question
    By donsgirl1015 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 03-04-2014, 07:42 AM
  2. Billing BCBS for ASC
    By nglover2001 in forum Billing/Reimbursement
    Replies: 0
    Last Post: 05-29-2013, 08:35 AM
  3. Billing BCBS question
    By nglover2001 in forum Outpatient Facilities
    Replies: 0
    Last Post: 05-23-2013, 10:00 AM
  4. Billing 76942 for bcbs
    By mconnolly in forum Orthopaedics
    Replies: 0
    Last Post: 10-11-2012, 01:36 PM
  5. Billing PA Assists BCBS Michigan
    By acbarnes in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 12-28-2007, 01:44 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.