August 2006 Issue
The future of your practice depends on knowledgeable billing and collection information. Understanding the full aspect of billing guidelines and procedures will effectively increase your reimbursement. This informative column will help providers and their staff with a better understanding of billing procedures and reimbursement strategies.
Q: I always read your column with great interest, and have learned much doing so. However, in the June issue, your second question deals with Region B and code K-0628. To my knowledge, that is not a valid code for 2006, and has been replaced by A-5512. Your comments please!
A: You are absolutely correct. As I stated in the May 2006 issue, effective January 1, 2006, K-0628 was replaced by A-5512 and K-0629 was replaced by A-5513. The allowable for A-5512 is $24.22 and for A-5513 $36.14 per insert.
Q: I am a Region A provider and would like to start receiving my checks directly in my account. Can you tell me whom I need to contact to have this change made?
A: There are three steps you need to take in order to start receiving funds via electronic funds transfer (EFT). You will first need to complete the CMS-588 EFT form which can be found at www.new.cms.hhs.gov/cmsforms/downloads/CMS588.pdf. You also need to send a voided business check with the suppliers name, address, and bank account number. Mail the voided check and signed CMS form to National Heritage Insurance, 75 Sgt. William Terry Drive, Hingham, MA 02044, Attn: DME EFT.
Q: I received an overpayment from Medicare and would like to refund the money as soon as possible. Do I need to send in a check to Medicare, and what else should I do? Do I need to contact Medicare first?
A: If you wish to mail a check back to Medicare, send it to AdminaStar Federal-PCU-DMERC Indiana, Lockbox #660078, Indianapolis, Indiana 46266-0078. Another option would be to have DMERC take the money back via an offset. An offset request form can be found at www.adminastar.com/Providers/DMERC/MedicareManuals/files/OffsetRequestForm.pdf
We invite readers to ask questions regarding billing, collections, or related subjects. For more information, contact firstname.lastname@example.org. Acc-Q-Data provides billing, collections, and practice management software and has served the O&P industry nationwide for more than a decade.
Lisa Lake-Salmon is Executive Vice President, Acc-Q-Data Inc.