Please help

Here's my dilema, I startted a mobile x-ray company along with another guy. We applied for a medicare provider number and are in the process of waiting for approval, in the meantime, our billing agency told us that we can obtain contracts with different doctors while we are waiting to get approved, at least this way we can generate revenue while waiting. Here's the problem, even after our billing agency and about 4 other doctors told us that this is perfectly legal, my partner insists that it is not. I mean, how are we going to even know who the doctor is billing? How would this be illegal with medicare, a woman from trailblazer even said it's not allowable, but our medical director and billing agency insists that it is perfectly allowable and say the medicare rep is wrong. Please help, thanks

Can you go into an office and expedite the paper work?

www.cms.hhs.gov/NationalProvIdentStand/

Thanks guys, but I cannot seem to find a clear answer to my question. If we don't have a medicare provider number yet and we have a contract with a doctor that pays pays us as per the contract, even if he is billing medicare for the patient that we x-rayed, is there any recourse from medicare, or any other insurance provider? Basically, if he pays us after he bills medicare for services that we did on his patient, is this legal? Thanks

Dave M. in Mission, Texas said: is this legal? Thanks

My suggestion (as implied with the link to the proper authority) is that you seek legal advice from either an attorney or the authority involved. I don't mean that as being snotty, it is just that it makes logical sense.

Here is my way of thinking... If someone here tells you it is legal and you do it and it turns out to be illegal where will you be? That is basically the reason it is improper to give legal advice without the proper credentials. In any business situation that involves legal matters, the best course of action is to seek competent legal advice or the advice of the authority that governs such matters.

you're absolutely right Charlie, I have an appointment with an attorney tomorrow afternoon. I was jut curios awhat everyone's thoughts in this message board were. Thanks in advance

Dave M. in Mission, Texas said: you're absolutely right Charlie, I have an appointment with an attorney tomorrow afternoon. I was jut curios awhat everyone's thoughts in this message board were. Thanks in advance

Well if all you want is a non-professional opinion, I will give you that...

My opinion is that it is probably legal as long as you can actually show that you have followed the proper procedures and have applied in good faith for the provider number. I understand that in other such business situations that an application for a patent allows one to go ahead and produce the widget while the patent search is pending. That is why you often see a product marked "Patent Pending."

The problem arises (in that case) that if the search reveals someone else has already been awarded patent rights, then you are forced to pay them royalties on what you have sold under their patent and to be forced to make a deal with the patent holder to remain in business and continue to produce that product.

In a service business such as yours, if it comes to an illegal act, however, you might be at great risk of a tremendous fine or worse. Best to take the advice of the attorney. At least you'll have some recourse to be able to show the attorney steered you wrong if that be the case. :)

How is business going? I 'm thinking to start same business in Chicago, but have a lot of doubts.
Can you email me at vitoldas2001@yahoo.com

thanks

Business is going very well so far, we are still waiting for our medicare provider number but still have plenty of work with jails and private pay patients. So far, so good.

So which billing company did you chose, how much they charge? I need find one too. Can you give me that company contacts?
Did you buy that new DR portable for 140 thousant, or you working with CR equipment?
Did you rent office space, or just working from home?

Thank you for your help.

Dave M. in Mission, Texas said: Here's my dilema, I startted a mobile x-ray company along with another guy. We applied for a medicare provider number and are in the process of waiting for approval, in the meantime, our billing agency told us that we can obtain contracts with different doctors while we are waiting to get approved, at least this way we can generate revenue while waiting. Here's the problem, even after our billing agency and about 4 other doctors told us that this is perfectly legal, my partner insists that it is not. I mean, how are we going to even know who the doctor is billing? How would this be illegal with medicare, a woman from trailblazer even said it's not allowable, but our medical director and billing agency insists that it is perfectly allowable and say the medicare rep is wrong. Please help, thanks

I'm sure it is ok but call Medicare and they will let you know all the payors follow Medicare guidlines so you should be ok

Vito in Evanston, Illinois said: So which billing company did you chose, how much they charge? I need find one too. Can you give me that company contacts?
Did you buy that new DR portable for 140 thousant, or you working with CR equipment?
Did you rent office space, or just working from home?

Thank you for your help.

I'm a billing company and would like to help you with anything you need I charge 6% and a small start up fee.

I have a wonderful system that sends everything electronic and denial managment and your reports are great let's talk.

Andrea

Andrea in Alfred Station, New York said: I'm a billing company and would like to help you with anything you need I charge 6% and a small start up fee.

I have a wonderful system that sends everything electronic and denial managment and your reports are great let's talk.

Andrea

I work from home and do billing for people like yourself. I can get your payors all set up for you and do all your credential that you need and do your billing. I would charge a small set up fee and 6% a month on what I bring in for your company. Let's talk

Andrea

Dave M. in Mission, Texas said: Here's my dilema, I startted a mobile x-ray company along with another guy. We applied for a medicare provider number and are in the process of waiting for approval, in the meantime, our billing agency told us that we can obtain contracts with different doctors while we are waiting to get approved, at least this way we can generate revenue while waiting. Here's the problem, even after our billing agency and about 4 other doctors told us that this is perfectly legal, my partner insists that it is not. I mean, how are we going to even know who the doctor is billing? How would this be illegal with medicare, a woman from trailblazer even said it's not allowable, but our medical director and billing agency insists that it is perfectly allowable and say the medicare rep is wrong. Please help, thanks

I am currently credentialing a new UrgentCare Facility in Michigan. I was told by WPS Medicare that your effective date is the date you signed your applications. Medicare also told me that your facility has to open and doing business when you apply. I can tell you that I only have 3 insurance approvals right now, MR is not one, and we have been fully open for about 1 month, we've seen about 200 pt's already, also please LISTEN TO THE PEOPLE WHO DO CREDENTIALING as part of their job! I'm sure they've been down this road a time or ten!

You can bill for any services to Medicare if the doctor has a upin # or NPI#

You have to use your NPI.

We provide a wide range of Practice Management Solutions for medical practices.

I would be very careful with the ideal of purchased services. There are various guidelines a participating Medicare provider must follow. If you are not enrolled with Medicare you are not billing Medicare therefore; some of your guidelines are slightly different. The company billing Medicare has the greatest liability.

For all of your billing and coding questions please visit our website. www.compliance1stsol.com

Dave M. in Mission, Texas said: Here's my dilema, I startted a mobile x-ray company along with another guy. We applied for a medicare provider number and are in the process of waiting for approval, in the meantime, our billing agency told us that we can obtain contracts with different doctors while we are waiting to get approved, at least this way we can generate revenue while waiting. Here's the problem, even after our billing agency and about 4 other doctors told us that this is perfectly legal, my partner insists that it is not. I mean, how are we going to even know who the doctor is billing? How would this be illegal with medicare, a woman from trailblazer even said it's not allowable, but our medical director and billing agency insists that it is perfectly allowable and say the medicare rep is wrong. Please help, thanks

Do not give up. The reps are trained to milead you, so thay they are going to be responsible for your bill. As sad as it souds,dear loved one; it is unfortunate that the highest paid insurance in america, will not even pay or give a damn about your condition. That is why thay hire the elite government's attorneys to outline the the insurance policy for Medicare. It is a evil and disgusting tragedy thay our Country faces today; and nobody gives a damn; just like the election in 2000. It was hacked democracy; and we have the evidence to prove it.

Very sadly,

A co-American

You already know who I am so why bother (Patriot Act)saying who I am. As I ponder our Wonderfu Country and how is was founded by our Father's of the United States of America, I feel that we are no longer a free Country; we are like the County we are fighting-only organized. We have managed to put on a facade, (pretending to be a Country that we are not). like an Oscor winner in Hollywood; we are good at that(how sad we are). I am only single mother with, one child, and doing best I can to raise him in this pretend Country that we live in. Don't get me wrong, I thing the U.S. is the best in all the world; however, there is more than a house; three kids; money in bank, and good time, all the time. I fee for those who are less fortunate; I was one of them myself,and still is. God is our hope and future. God, please bless our Country.

Me

Andrea in Alfred Station, New York said: I'm a billing company and would like to help you with anything you need I charge 6% and a small start up fee.

I have a wonderful system that sends everything electronic and denial managment and your reports are great let's talk.

Andrea

What is your contact info?

JOE in Hot Springs Village, Arkansas said: What is your contact info?

I need billing services for portable x-ray company.

vitoldas2001@yahoo.com

Dave M. in Mission, Texas said: Here's my dilema, I startted a mobile x-ray company along with another guy. We applied for a medicare provider number and are in the process of waiting for approval, in the meantime, our billing agency told us that we can obtain contracts with different doctors while we are waiting to get approved, at least this way we can generate revenue while waiting. Here's the problem, even after our billing agency and about 4 other doctors told us that this is perfectly legal, my partner insists that it is not. I mean, how are we going to even know who the doctor is billing? How would this be illegal with medicare, a woman from trailblazer even said it's not allowable, but our medical director and billing agency insists that it is perfectly allowable and say the medicare rep is wrong. Please help, thanks

Dave, did you receive your MPN?
I started Prtable x-ray services one year ago and submited all forms to MEDICARE for my MPN, however I still waiting for site survey from Department of Public Health. I was told that they don't have any resources to provide site inspections for new portable x-ray providers, and MEDICARE told me that I can't see medicare patients without MPN. So I got stuck!!!!!!!!!

what did you find out? it is sticky when it comes to SNF(called "sniff") patients, you cannot charge a medicare patient one charge and a private ins another. It has to be equal.

i want to start a xray companie.. can someone guide me to a direction where i should be looking at... how much investment should i need to get bussins runinig

I don't know how the billing is going, but if you are interested in getting some more information regarding a good billing company let me know. I ran a portable x-ray company on the gulf coast of Florida since 1989 and we just sold it to Mobilex USA in 2007. After we sold our x-ray company we started a billing company, and believe me we know x-ray & ultrasound billing inside and out. Our collection rate was over 95% and we have certified billing and coding experts. Let me know if we can help.
johnknowles1@verizon.net

John, do you have experience in PPS billing, as well as the other levels of billing for LTAC and SNF?

Jason in Dacula, Georgia said: John, do you have experience in PPS billing, as well as the other levels of billing for LTAC and SNF?

The billing 'levels' you're referring to are abreviations. there are only 2 types of medical services. Inpatient and outpatient. Medicare has 4 parts- A,B,C, and D. Prospective payment systems (PPS) is a CMS term used by Part A-inpatient healthcare agencies ie:(hospitals, long term acute care, skilled nursing facilities) to calculate amount of reimbursement by CMS. The payments are determined by clinical info(diagnostic and procedural codes),in each patient file. Go to cms.gov website for any guidelines, CMS writes the rules.

Paula, I understand that in as far as true inpatient procedural billing. However, my question, more specifically, is when a 3rd party renders service to that PPS patient, how would billing be handled.

Example. An xray technician shows up and takes a chest xray, then sends the file to a of site physcian who renders the report back to the patients location.... all that data would need to be 100% correct 100% of the time to ensure reimbursement and to make things stickier, the patient, the xray tech and the rendering physician can often all 3 be in different states... tele-radiology at its finest!

hi Jason, if the services were provided to a Medicare Part A resident in a SNF setting , this is going to be a part of consolidated billing, and the facility is responsible for the payment regardless of locations. HCPC codes listed as part of consolidated billing is going to be at facility's cost. The only time these HCPCS codes can be billed is when patient is off skilled inpatient services, claim then can be submitted to Medicare B. Hope this helps.

All I would like to know is, I work for a company as a residential supervisor, I do some billing for them for medical transportation and billing for daily living services. I do not have any type of license, I just bill for the company I work for. Why would I need an NPI number?

With the exception of Vito, I would be happy to discuss any of your billing, operational, marketing or regulatory matters for your (or others) Portable X-Ray Business. I am the #1 Consultant in the USA and have successful clients from "coast to coast."

Please visit my web site for more info, www.mobilexrayconsultant.com

Kevin McDonough, R.T. (R)
"Mr. Mobile X-Ray"

Hey I am having trouble with how to bill private insurances for portable x-ray services.
I am a NON-Physician owned co. with a supervising physician. Would i have to be credentialled with each carrier or do i bill out under sup. physician. any help out there? I am medicare certified lic/ins, nysdoh certified.

Hey I am having trouble with how to bill private insurances for portable x-ray services.
I am a NON-Physician owned co. with a supervising physician. Would i have to be credentialled with each carrier or do i bill out under sup. physician. any help out there? I am medicare certified lic/ins, nysdoh certified.

With the exception of Vito, I would be happy to discuss any of your billing, operational, marketing or regulatory matters for your (or others) Portable X-Ray Business. I am the #1 Consultant in the USA and have successful clients from "coast to coast."

Please visit my web site for more info:
www.mobilexrayconsultant.com

Kevin McDonough, R.T. (R)
MrMobileXRay on Twitter
mobilexrayconsultant@gmail.com