Sunday, November 3, 2024

Medicare of Puerto Rico

Melissa Edwards

Hello All,

We currently have a patient that has Medicare and they are from Puerto Rico. We have had trouble getting paid on the claim. It is managed by BC/BS and the ID number does not have prefix. We were assured by the eligibility and benefits department that it was correct and we received benefits upon the inquiry. However, when we billed the claim to our local as they stated was proper procedure, we now have received a denial because there was not a prefix associated with the ID number.

When we called the claims department, we were told they could not even look up the ID number without a Prefix.

So my question is, has anyone else successfully billed Medicare Anthem of Puerto Rico?

Thank you in advance.

Best,

Melissa Edwards
Chief Compliance Officer
Administrative Supervisor

[New Logo- VP&O B&W]

4338 Williamson Rd. NW
Roanoke, VA 24012
P:(540) 366-8287
F: (540) 767-0010
[email protected]
THE DOCUMENTS ACCOMPANYING THIS TRANSMISSION CONTAIN CONFIDENTIAL HEALTH INFORMATION THAT IS LEGALLY PRIVILEGED. THIS INFORMATION IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY NAMED ABOVE. THE AUTHORIZED RECEIPIENT OF THIS INFORMATION IS PROHIBITED FROM DISCLOSING THIS INFORMATION TO ANY OTHER PARTY UNLESS REQUIRED TO DO SO BY LAW OR REGULATION AND IS REQUIRED TO DESTROY THE INFORMATION AFTER ITS STATED NEED HAS BEEN FULFILLED.
IF YOU ARE NOT THE INTENDED RECIPIENT, YOU ARE HEREBY NOTIFIED THAT ANY DISCLOSURE, COPYING DISTRIBUTION, OR ACTION TAKEN IN RELIANCE ON THE CONTENTS OF THESE DOCUMENTS IS STRICTLY PROHIBITED. IF YOU RECEIVED THIS INFORMATION IN ERROR, PLEASE NOTIFY THE SENDER IMMEDIATELY AND ARRANGE FOR THE RETURN OR DESTRUCTION OF THESE DOCUMENTS.

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