Re: medicare reimbursement

[Guest guest]

Joe

If you are a participating provider, you will be paid accordingly.? It will not

matter whether the referral source is participating or not.

Jim <///><

medicare reimbursement

Had a quick question for the group.? I am a PT in private practice and

participate with medicare.? We received a referral from an MD that does not

participate with medicare.? Will we be reimbursed in the usual manner of a

participating provider when we submit bills to medicare or, in this case, will

the patients charges be considered from a non-par?

Thanks,

Joe Durham PT, DPT, OCS, MSHA ?

[Guest guest]

Just be certain that the referring provider is actually enrolled in Medicare.

Beginning October 1st, 2009 edits will be in place to verify that the referring

provider is enrolled in the Medicare program (could be par or non-par) and if

he/she is not found to be enrolled, claims will not be paid.

See:

http://www.cms.hhs.gov/ContractorLearningResources/downloads/JA6417.pdf

Cheri Freeman, CMRS

CRT Healthcare Mgm't Systems

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> Joe

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> If you are a participating provider, you will be paid accordingly.? It will

not matter whether the referral source is participating or not.

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> Jim <///><

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> medicare reimbursement

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> Had a quick question for the group.? I am a PT in private practice and

participate with medicare.? We received a referral from an MD that does not

participate with medicare.? Will we be reimbursed in the usual manner of a

participating provider when we submit bills to medicare or, in this case, will

the patients charges be considered from a non-par?

>

> Thanks,

>

> Joe Durham PT, DPT, OCS, MSHA ?

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>

[Guest guest]

We have found that if the referring MD does not participate in Medicare then

they usually do not have a NPI number, don't participate in BCBS... These types

of physicians run the cash only clinics. " see the doc for $40 " If we get a

referral from them we notify the patient that if they want Medicare or their

insurance to pay then they have see a MD with the above stated information, or

pay cash for services and deal with their carrier.

We do not get paid if the referring MD does not have a NPI number.

Roll PT, OCS, FAAOMPT

Ocean Springs, MS

www.ptcos.com

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> > Joe

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> > If you are a participating provider, you will be paid accordingly.? It will

not matter whether the referral source is participating or not.

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> > Jim <///><

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> > medicare reimbursement

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> > Had a quick question for the group.? I am a PT in private practice and

participate with medicare.? We received a referral from an MD that does not

participate with medicare.? Will we be reimbursed in the usual manner of a

participating provider when we submit bills to medicare or, in this case, will

the patients charges be considered from a non-par?

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> > Thanks,

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> > Joe Durham PT, DPT, OCS, MSHA ?

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