MEDICARE ADVANTAGE PLANS

While you're on the subject of billing, does anyone have a handle on Medicare Advantage Plan Billing. Is there a magical system. I have been billing Medicare Advantage claims for several years and it has always been a pain. I called the help desk at Anthem and the person I spoke to did not know what home health was. I'm serious. She rejected a RAP because it had code 0023 in the Revenue section. I don't believe it is our responsibility as billers to explain RAPs and Finals.

I just returned from a Home Health/Hospice workshop last week and everyone I spoke with was having problems with Medicare Advantage Claims. At this point I'm ready to attend a special seminar if there is one to resolve this issue.

I fear that there will be more and more of Medicare Advantage Plans rather than straight Medicare in the future.

I thank you in advance for any comments or answers you may provide.

Thanks Again,

Stephen A. Dixon
Dixon Healthcare Billing Solutions, Inc.
239-405-0399
sadixonhcs@earthlink.net

Comments

  • It is important to first determine which of your managed Medicare plans are still under a FFS reimbursement methodology and which ones are under the PPS methodology. There are FFS plans out there that have begun requiring the 0023 HIPPS line on all FFS claims.


    Raymond Herman
    Finance Manager
    CKHS Home Health & Hospice
    200 West Sproul Road
    Springfield, PA 19064
    610-638-1515


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