5 Tips to Making Medicare Billing Easy
Billing Medicare is actually quite simple, as long as you have everything lined up correctly. Here are some tips to help make your billing more streamlined and prevent denials!
Use your EHR (if possible). Everything is already captured in your EHR, meaning you don’t need to enter client info into another system. Using one less system means less mistakes, less stress, and less work for you trying to reconcile everything. Note: if using Simple Practice, you do need to enroll to bill Medicare and this can take 6-8 weeks.
Ensure your provider information is correct and matches Medicare. If you are credentialed with Medicare using your NPI2, you need to bill that way. The information for you as the provider needs to match exactly with that Medicare has on file including your address, NPI, and name. Make sure your EHR is set up correctly with this information.
Check your clients' benefits. Always, always confirm eligibility! Many clients do not understand the difference between a Medicare Advantage plan and Traditional Medicare. Check their benefits so you make sure you’re billing the correct plan (and so you don’t miss out on money).
Make sure client info is correct. Look over the client's information in your EHR/billing system and ensure it’s entered correctly. Their name needs to be listed on the claim exactly as it shows on their Medicare card. Also, enter their Medicare ID on the claim with no dashes.
Use the correct modifier. Telehealth is still billed as your normal place of service (11, office for most) with the modifier 95- this includes audio. If you use 02 or 10 for the place of service, you will get paid less. Medicare Advantage plans vary by state and plan so you will need to check with each individual plan if billing Medicare Advantage for proper telehealth modifiers.
Keep these tips handy for reference when billing to lessen any possible errors!
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