Medicare denials

[Guest guest]

Rachel -

Thanks! You mention the " health insurance claim number, dob, and

their Medicare number " - by health insurance claim number do you mean

their secondary ins. member ID?

-Ben

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> Re: Know how to get Medicare denials

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> Posted by: " mageehermionemagee "

> Racheldiaz

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<Racheldiaz?Subject=%20Re%3A%20Know%20how%20to%20g\

et%20Medicare%20denials>

> mageehermionemagee

> <http://profiles./mageehermionemagee>

>

>

> Fri Mar 7, 2008 1:21 pm (PST)

>

> Chinese Medicine

> <Chinese Medicine%40>, " Benjamin

> Hawes,

> L.Ac. " <bhawes wrote:

> >

> > For U.S. Practitioners:

> > Has anyone figured out how to submit AP (acupuncture) claims to

> Medicare

> > explicitly for rejections to send to secondary insurance? So far

> I've

> > had no luck, except when patients have sent in their own claims for

> > denial or when I have called the secondary insurer to plead that

> I'm not

> > a Medicare provider and Medicare doesn't cover AP anyway (some will

> > manually reprocess the claims without a Medicare paysheet). Since

> I'm

> > not an MD, I can't figure out how to get past the Medicare

> requirement

> > that I have a provider PIN to get claims to them. Anyone know?

> > Thanks.

> > Ben Hawes, L.Ac.

> >

> >

>

> I have done this process a couple of times...I send a letter to

> Medicare with the patient's health insurance claim number, dob, and

> their Medicare number. In the letter I just tell them that I am in

> need of a letter from them stating that " Medicare does not cover or

> pay for acupuncture services... " They then have sent me back a

> letter stating such and initially, when I bill, I submit a copy of

> that letter to the second party insurance company as verification.

> This process does take a few weeks so just be aware of that.

>

> Write to:

>

> Nordian Administrative Services, LLC

> A CMS Contracted Carrier

> 901 40th Street S, Suite 1

> Fargo, ND 58103-2146

>

> (CMS= " Centers for Medicare & Medicaid Services).

>

> Good Luck!

>

> Rachel Diaz

>

> >