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-> Working Women
amother
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 Tue, Oct 08 2024, 3:21 pm
I do billing for a nursing home in NY. Currently, any time we have a patient with Medicare and an HMO secondary, we mail out the claim to the secondary insurance with the Medicare EOB attached.
Its getting increasingly frustrating as so many of the claims are not being uploaded on file. We do use certified tracking, but it doesnt really help.
I never have this issue with claims that are submitted electronically, but we cant submit coinsurance claims electronically because our system does not support attachments.
I am literally spending hours chasing these claims and trying to get them on file.
Does anyone work in this field have a good solution?
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cutewife
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Tue, Oct 08 2024, 4:07 pm
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I've had luck with faxing the claim and eob
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amother
Cerulean
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Tue, Oct 08 2024, 4:33 pm
I second faxing. A lot of companies accept it.
Also which clearinghouse do u use for billing?
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cutewife
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Tue, Oct 08 2024, 4:56 pm
Ive used zirmed and change. Faxing always works.
For the MLTC tho you can upload on Zirmed bec you just need denials for them
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amother
Impatiens
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Tue, Oct 08 2024, 5:28 pm
| amother OP wrote: | I do billing for a nursing home in NY. Currently, any time we have a patient with Medicare and an HMO secondary, we mail out the claim to the secondary insurance with the Medicare EOB attached.
Its getting increasingly frustrating as so many of the claims are not being uploaded on file. We do use certified tracking, but it doesnt really help.
I never have this issue with claims that are submitted electronically, but we cant submit coinsurance claims electronically because our system does not support attachments.
I am literally spending hours chasing these claims and trying to get them on file.
Does anyone work in this field have a good solution? |
Why not bill electronically? The EDI Medicare payment info is included in the electronic file.
What billing system do you use? DKS (David Klein) and PCC can def bill electronic claims
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cutewife
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Tue, Oct 08 2024, 6:14 pm
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In my experience we did only the medicaid co insurance electronically
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amother
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Wed, Oct 09 2024, 10:50 am
I use Zirmed/Waystar. They support attchments?
Which insurance accept faxed claims? Currently having issues with Fidelis, Metroplus, Senior Whole Health, Elderserve
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amother
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Wed, Oct 09 2024, 11:03 am
| cutewife wrote: | Ive used zirmed and change. Faxing always works.
For the MLTC tho you can upload on Zirmed bec you just need denials for them |
What do you mean by this? Why do you just need denials and not payments?
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cutewife
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Wed, Oct 09 2024, 11:44 am
| amother OP wrote: | | What do you mean by this? Why do you just need denials and not payments? |
In ny and nj the mltc/mcd barely pay a coinsurance claim
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