{"id":4151,"date":"2012-12-18T18:30:04","date_gmt":"2012-12-18T23:30:04","guid":{"rendered":"http:\/\/www.poweryourpractice.com\/?p=4151"},"modified":"2012-12-18T18:30:04","modified_gmt":"2012-12-18T23:30:04","slug":"submit-medicare-claims-correctly-avoid-denials","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/submit-medicare-claims-correctly-avoid-denials\/","title":{"rendered":"How to Submit Medicare Claims Correctly and Avoid Costly Denials"},"content":{"rendered":"<p>Medicare denials have become much more frequent of late and can be very costly.\u00a0 For instance, we at Medical Billing, Inc. been getting an unprecedented amount of denials for \u201cname and ID# do not match.\u201d<\/p>\n<p>And we&#8217;re getting these denials on claims for providers who have been seeing and <strong>getting paid on claims for these same patients for months or even years.<\/strong><\/p>\n<p><!--more-->Why now are these claims denying for name and ID do not to match?\u00a0 Good question. We\u2019ve called Medicare several times and were told the name and ID do not match.\u00a0 That\u2019s all they would tell us, <strong>just as the EOB reflected.<\/strong><\/p>\n<p>We would explain that we were paid for previous dates but it didn\u2019t matter to the representative.\u00a0 The name and ID did not match.<\/p>\n<p>Finally, we got to the bottom of this challenge!\u00a0 We spoke with a helpful Medicare representative who gave us the answer.\u00a0 The error can be owed to a <strong>recent change in their processing guidelines.<\/strong><\/p>\n<p>Any claim now submitted to Medicare must be entered exactly as the ID card shows.\u00a0 If there is a middle initial, then your claim must have a middle initial.\u00a0 If there is a hyphenated name, the hyphen must be included. If there is a space, space must be included. \u00a0And of course, if you have misspelled the name, the claim will be denied.<\/p>\n<p>It is now extremely important to get a copy of the patient\u2019s ID card so you can be sure you have it exactly as represented on the card.\u00a0 <strong>In fact, we have had claims denied that did match exactly.<\/strong>\u00a0 Only after speaking to a representative and proving the claim matched the ID card would Medicare pay.<\/p>\n<p>Furthermore, we have also found Medicare claims denied where the patient&#8217;s name on the denial is completely different than the name we submitted.\u00a0 When we called on this claim and the representative looked at it, we were told they could see that we submitted with the correct name and they weren\u2019t sure what changed it in the system, but they would reprocess.<\/p>\n<p>In short, it seems to us that Medicare is making it harder than ever to get claims correctly processed.\u00a0 <strong>Maybe it is a money-saving technique on their part.\u00a0<\/strong> If your office is not following up on these denials and running regular aging reports, you are losing lots of money.<\/p>\n<p>Make sure your office is not missing out on payment for these claims.\u00a0 Take care of the denials using whatever steps are necessary.\u00a0 Run and work on regular aging reports to avoid timely filing issues.<\/p>\n<p>Make sure you quickly remedy these issues.\u00a0 Ask your patients to present their ID cards and keep copies of them on file.\u00a0 When you get any denials act on them immediately.\u00a0 Don\u2019t put them away for when you have time.\u00a0 These problems need to be dealt with quickly.<\/p>\n<p><strong>How have you dealt with denied Medicare claims? Let us know in the comments section!<\/strong><\/p>\n<p><strong>For more useful articles like these, sign up for our newsletter!<\/strong><\/p>\n<p>Enter Your Email: Sign Up Now<\/p>\n<p><em><a href=\"https:\/\/www.carecloud.com\/continuum\/wp-content\/uploads\/2011\/11\/alice-bio-picture.jpg\"><img decoding=\"async\" class=\"size-full wp-image-19079 alignleft\" src=\"https:\/\/www.carecloud.com\/continuum\/wp-content\/uploads\/2011\/11\/alice-bio-picture.jpg\" alt=\"\" width=\"100\" height=\"107\" \/><\/a>Alice Scott and Michele Redmond are medical billing experts, co-owners of Solutions Medical Billing Inc in Rome, N Y., and coauthors of 15 books on medical billing and medical credentialing. Their newest title is\u00a0<a href=\"http:\/\/www.medicalbillinglive.com\/medical-billing-marketing.shtml\" target=\"_blank\" rel=\"noopener\">Advanced Medical Billing Marketing for the New Economy<\/a>.<\/em><\/p>\n<p><em>This mother-and-daughter team maintains two medical billing websites, a free newsletter, and an active forum. Alice and Michele are on the editorial staff of BC Advantage and are regular contributors to the magazine. Their books are available at\u00a0<a href=\"http:\/\/www.medicalbillinglive.com\/\" target=\"_blank\" rel=\"noopener\">www.medicalbillinglive.com<\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Medicare denials have become much more frequent of late and can be very costly.\u00a0 For instance, we at Medical Billing, Inc. been getting an unprecedented amount of denials for \u201cname and ID# do not match.\u201d And we&#8217;re getting these denials on claims for providers who have been seeing and getting paid on claims for these [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":32784,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-4151","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revenue"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>How to Submit Medicare Claims and Avoid Costly Denials<\/title>\n<meta name=\"description\" content=\"How have you dealt with denied Medicare claims? 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