You’re a wonderful teacher. I only understood 1/2 of what you were saying on first go round but I’m confident I’ll be able to get through this bureaucratic maze with your assistance. Thank you so much.🙂
I have been trying to understand this and to this point, still confused on all the information. I have not been paid since mid June due to the changes and not really understanding the process. Would you be willing to do a one on one tutoring session?
Loved the video! I have been enrolled in medicare with my previous employers. I recently left to start on my own. Do I have to submit a new enrollment application on PECOS? Or apply for a reassignment?
Yes, you will need to submit a new enrollment. Have you received a type 2 organizational NPI for your business yet? If you want a video tutorial taking you through the entire process you can use this coupon code. It makes the course $12.99 - www.udemy.com/course/medicare-provider-enrollment-pt/?referralCode=A6500D79F2386849283E
Great video Anthony. I have been submitting myself through the MAC portal for 2 years now because historically I have so few medicare claims. Now I have more medicare visits and a back log of claims to submit. I am trying to decide between Office Ally and Just hiring a biller. Please shed some light what volumes may lead to one decision vs. another. If I pay one of my clerical staff to do the Office Ally work, would I be smarter to pay a biller? Thank you for any insight.
New Seasons Physical Therapy and Wellness, PLC I LOVE this question. I will create a full video on the topic but for now I would like to know how long it takes you to enter 10 claims on average via the Mac portal. I say 10 because 1 can be quick and easy with practice. 10 would be a better representation of the real time and workload. My guess is 1 hour, but don’t let that influence you.
I bill for a mental health provider who just got his Ptan. He has an old NPI that has been used in the past 5 years since I've been billing for him, and now due to incorporating with his wife that corporation had to be used for the PTAN paperwork and now my boss has a new NPI. Old claims that we are now trying to finally get paid as 2nd insurance have the old NPI listed on the 1st insurance EOB. Now I need to bill Medicare which has his new NPI. How do I navigate this?
His NPI should be his personal NPI (type 1 NPI) then the business should have a new NPI (type 2 NPI) I am not very familiar with mental health services, but I would suggest any of the claims that were processed with the previous NPI should stay with that NPI and any new/future claims should use the new NPI. You should be able to essentially have two billing provider options in your software. One with the original information to finish the claims that were processed by the primary using the old info, and a second with the new info for new claims.
I am currently working on my start-up business for Mobile Therapy. I do have an NPI number, but it is with my current OP clinic and it is linked to their address. I read that you only have one NPI number, but this seems like it could get messy when it comes to billing. Do I need to apply for another one with my private address? Also, if someone has Medicare Advantage, do you still have to bill the insurance vs accepting cash pay? I am loving yours and David Bayliff's videos. If I can get this billing thing figured out, I hope to start with it by the end of July!
I teach a very comprehensive nine hour course on Medicare billing. It takes a provider from knowing nothing to knowing everything required to submit a claim and get paid. The course is taught live and all the training is then recorded and available for replay. www.LearnMedicarebilling.com
Your current NPI is with you not your employer. If you have created a company for your mobile practice you will need to apply for an organizational type to NPI. Then you’ll need to submit a new initial enrollment with Medicare for yourself and your company. Currently, your NPI is reassigned to your employer. You may have multiple reassignments in place. That is how Medicare keeps track of the therapist treating the patient and where to send payments.
ERA's are critical to keep track of payments/accounting. I'm a biller for a psychologist and we are thinking about switching to Office Ally. Thanks for the walkthrough.
The one thing that scares me when starting my new med billing company are how will i get the patient info from the provider into office alley as some ppl still use paper , or some just scheduling software . What would you say the best way is ?
Hello Anthony, thanks for the info. I just got my Med B provider # for MD as a sole proprietor. Didn't know I could have been setting up the EDI, but unfortunately. I have had an unexpected change in my living situation. I am looking now at housing options and may end up just across the MD border in West Virginia. Only a 25 minute drive in to a small town in MD. Is there a way to set myself up to see MD patients? I already of course have a MD license. Can I hire a PT indep contractor in MD eventually? Thanks in advance for your time.
Great question. We just confirmed today that most MAC's (maybe all) require an address in the state in which you are treating patients. I honestly don't know how to work around that. If you can afford a small office, rent may be cheap right now and you could use that as an office to see patients or just for admin purposes.
Hi, total beginner here, do I still need above(in the video) when I use EMR like Jane/simple practice/web PT? I'm looking for the simplest option for cash+medicare for pelvic PT. Thank you in advance!
This was so incredible. I would love to connect. I have a question I needed help with. I needed help with the PTAN and I have a Medicare enrollment question
Thanks for the video. I know I had a Medicare Part B number very long time ago. But since then, I have done home health under Part A. I want to start my own mobile clinic. where do I go to find out my Medicare Part B number?
I am an SLP new to private practice. I am going to be using SimplePractice for EMR, billing, teleplatform. Are you saying that I would need a clearinghouse also? I thought SimplePractice would allow me to complete the billing process. I am missing something? Thank you!
Hey Anthony great tips. I am setting up to be a Med B provider multigroup specialty home visit. Just wondering If I want to reassign PT or OT benefits to my company using 855r form how long is the process. And can they start treating patients and bill right away even if im waiting for 855r form to be processed?
Timeframe varies but 4-6 weeks is reasonable. Yes, the therapist can start billing while waiting but you must hold claims until reassignment is complete.
Office Ally charges $35/mo per rendering PT, OT, SLP There is no master list but some clearing houses charge per month regardless of claims, some charge by claim number regardless of providers. Some clearinghouses are not able to send claims to certain payers so you always want to check their payer list.
I am Acupuncturist , thank you for the video ! it is very helpful ! If there is an user instruction of office ally can be download, it will be greatly appreciated.
You’re a wonderful teacher. I only understood 1/2 of what you were saying on first go round but I’m confident I’ll be able to get through this bureaucratic maze with your assistance. Thank you so much.🙂
Amazing information. Thank you so much.
Thank you. I’m a mental health clinician and this information is very helpful.
This was incredibly helpful! Im an optometrist starting a new practice abs found this very valuable. Thank you
Glad it was helpful!
Thank you this video. this is very helpful. i need to know if i can upload my own PT note and add my signature to practice mate from office ally
You are a great teacher! Thank you.
Thank you so much for the kind words.
I have been trying to understand this and to this point, still confused on all the information. I have not been paid since mid June due to the changes and not really understanding the process. Would you be willing to do a one on one tutoring session?
Thanks Tony! So clear and concise.
Glad it was helpful!
I am Acupuncturist , thank you for the video ! it is so helpful !
You're so welcome!
Have you seen this article holisticbillingservices.com/acupuncture-insurance-billing-via-medicare
Loved the video! I have been enrolled in medicare with my previous employers. I recently left to start on my own. Do I have to submit a new enrollment application on PECOS? Or apply for a reassignment?
Yes, you will need to submit a new enrollment. Have you received a type 2 organizational NPI for your business yet? If you want a video tutorial taking you through the entire process you can use this coupon code. It makes the course $12.99 - www.udemy.com/course/medicare-provider-enrollment-pt/?referralCode=A6500D79F2386849283E
Doing this now for a PT.
a visual flow chart would be wonderful...did you create one?
I forgot about this. I will try to get on it for the next cohort.
So helpful! Thank you!
Glad it helped.
Great video Anthony. I have been submitting myself through the MAC portal for 2 years now because historically I have so few medicare claims. Now I have more medicare visits and a back log of claims to submit. I am trying to decide between Office Ally and Just hiring a biller. Please shed some light what volumes may lead to one decision vs. another. If I pay one of my clerical staff to do the Office Ally work, would I be smarter to pay a biller? Thank you for any insight.
New Seasons Physical Therapy and Wellness, PLC I LOVE this question. I will create a full video on the topic but for now I would like to know how long it takes you to enter 10 claims on average via the Mac portal.
I say 10 because 1 can be quick and easy with practice. 10 would be a better representation of the real time and workload. My guess is 1 hour, but don’t let that influence you.
Do I have to be a physical therapist to own a third-party clinic and be able to bill medicare?
It depends on your MAC and state. I recommend contacting the MAC to ask this question.
I bill for a mental health provider who just got his Ptan. He has an old NPI that has been used in the past 5 years since I've been billing for him, and now due to incorporating with his wife that corporation had to be used for the PTAN paperwork and now my boss has a new NPI. Old claims that we are now trying to finally get paid as 2nd insurance have the old NPI listed on the 1st insurance EOB. Now I need to bill Medicare which has his new NPI. How do I navigate this?
His NPI should be his personal NPI (type 1 NPI) then the business should have a new NPI (type 2 NPI) I am not very familiar with mental health services, but I would suggest any of the claims that were processed with the previous NPI should stay with that NPI and any new/future claims should use the new NPI.
You should be able to essentially have two billing provider options in your software. One with the original information to finish the claims that were processed by the primary using the old info, and a second with the new info for new claims.
You mentioned that you print your forms and send in notes with those forms. This is only if requested, right? You don't send in notes with each claim?
Right. Only if requested. Normally Medicare does not request or review documentation. You only submit claim forms.
When you say third step ; document do you mean like posting the payments ?
Thank you Sir
You are welcome.
I am currently working on my start-up business for Mobile Therapy. I do have an NPI number, but it is with my current OP clinic and it is linked to their address. I read that you only have one NPI number, but this seems like it could get messy when it comes to billing. Do I need to apply for another one with my private address?
Also, if someone has Medicare Advantage, do you still have to bill the insurance vs accepting cash pay?
I am loving yours and David Bayliff's videos. If I can get this billing thing figured out, I hope to start with it by the end of July!
I teach a very comprehensive nine hour course on Medicare billing. It takes a provider from knowing nothing to knowing everything required to submit a claim and get paid. The course is taught live and all the training is then recorded and available for replay.
www.LearnMedicarebilling.com
Your current NPI is with you not your employer. If you have created a company for your mobile practice you will need to apply for an organizational type to NPI. Then you’ll need to submit a new initial enrollment with Medicare for yourself and your company.
Currently, your NPI is reassigned to your employer. You may have multiple reassignments in place. That is how Medicare keeps track of the therapist treating the patient and where to send payments.
Wonderful info!!!
ERA's are critical to keep track of payments/accounting. I'm a biller for a psychologist and we are thinking about switching to Office Ally. Thanks for the walkthrough.
4tun8nanette yeah, I could do it without ERAs.
I am stuck w edi enrollment 😞 not sure how to complete Era and pc ace sections
The one thing that scares me when starting my new med billing company are how will i get the patient info from the provider into office alley as some ppl still use paper , or some just scheduling software . What would you say the best way is ?
Hello Anthony, thanks for the info. I just got my Med B provider # for MD as a sole proprietor. Didn't know I could have been setting up the EDI, but unfortunately. I have had an unexpected change in my living situation. I am looking now at housing options and may end up just across the MD border in West Virginia. Only a 25 minute drive in to a small town in MD. Is there a way to set myself up to see MD patients? I already of course have a MD license. Can I hire a PT indep contractor in MD eventually? Thanks in advance for your time.
Great question. We just confirmed today that most MAC's (maybe all) require an address in the state in which you are treating patients. I honestly don't know how to work around that. If you can afford a small office, rent may be cheap right now and you could use that as an office to see patients or just for admin purposes.
one picture is much better than thousands of words.
So Informative..do ypu have the flowsheet in submitting medicate claims? Txs
How to submit Homehealth care service in office ally?
can i hire you ?
Of course, but you can also try this: learnmedicarebilling.thinkific.com/courses/PECOS
Hi, total beginner here, do I still need above(in the video) when I use EMR like Jane/simple practice/web PT? I'm looking for the simplest option for cash+medicare for pelvic PT. Thank you in advance!
Just curious, what were your reasons for switching from Availity to Office Ally? I'm currently comparing both.
When we opened clinics in Ohio there were payers Availity was not contracted with.
so helpful!!!!
This was so incredible. I would love to connect. I have a question I needed help with. I needed help with the PTAN and I have a Medicare enrollment question
Thanks for the video. I know I had a Medicare Part B number very long time ago. But since then, I have done home health under Part A. I want to start my own mobile clinic. where do I go to find out my Medicare Part B number?
Thanks, Anthony!
I am an SLP new to private practice. I am going to be using SimplePractice for EMR, billing, teleplatform. Are you saying that I would need a clearinghouse also? I thought SimplePractice would allow me to complete the billing process. I am missing something? Thank you!
SimplePractice integrates with a clearinghouse so it should already be taken care of for you.
Hey Anthony great tips. I am setting up to be a Med B provider multigroup specialty home visit. Just wondering If I want to reassign PT or OT benefits to my company using 855r form how long is the process. And can they start treating patients and bill right away even if im waiting for 855r form to be processed?
Timeframe varies but 4-6 weeks is reasonable. Yes, the therapist can start billing while waiting but you must hold claims until reassignment is complete.
is there a master list w/pros/cons of clearinghouses? What did you say office ally charged?
Office Ally charges $35/mo per rendering PT, OT, SLP
There is no master list but some clearing houses charge per month regardless of claims, some charge by claim number regardless of providers. Some clearinghouses are not able to send claims to certain payers so you always want to check their payer list.
I am Acupuncturist , thank you for the video ! it is very helpful ! If there is an user instruction of office ally can be download, it will be greatly appreciated.
Very helpful, thank you!