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Hi there and thanks for watching! How exciting. Yes, that is most likely what they would do/how it should work. I encourage you to call his insurance and ask about their secondary coverage with your benefits as primary specifically. That way you’ll know for sure. Good luck!!

Thank you so much and I appreciate your support!! CLIA is only for laboratory tests. EKGs do not fall under that classification. Good luck!

Hi and thank you for watching. All states and the insurances have different requirements so you would need to check the specific telehealth contracting guidelines and requirements. Good luck!

Thanks!

@@shaktiranjanpanigrahi301 thank you for asking! It does vary based on the insurance, unfortunately. Great question and thank you for supporting my channel!

@@rickyaclickpowr2187 hi and thank you for asking. The video helps anyone not familiar with medical insurances and the credentialing process. Each section has a free overview of what is covered so viewers can see if they feel it would benefit them. Please take a look and good luck!

@@amandabrown3776 hi there and good question! Yes, you would still need a CLIA waiver to be able to run rapid tests, and you would need to ask your local health department that issues the waivers. The CLIA waiver application may even have this option to select as a mobile company, so you would need to check it out. Thanks for watching!

@@zahoorminhas you need to enroll the group using 855I and add the owner/provider on that application so they can be reassigned to that group. The 855R was discontinued but if you do it online via the pico website, it will fill it all out on the correct form for you.

Thank you, @navigatingthebusinessofmed8251, for your assistance! Could you guide me on which documents typically need to be uploaded with a Medicare application for both a group and a provider?

@ the application will walk you through what documents are needed, and who needs to sign them

@@navigatingthebusinessofmed8251 thank you I'm asking for most mandatory documents because there are list of more then 15 documents.

Yes, it is very sad how many claim rejection and denials are a result of not obtaining authorizations. Medical records should not need to be sent with claims if the authorization is obtained prior to services rendered, and the medical records being sent with the claim will not replace the need for an authorization either. Clinics definitely need to do their due diligence and understand what plans need these. I appreciate your participation on my video and for watching!!

Thanks for watching. I'm glad you found it helpful

@@modasalvador7435 thank you for watching!

@@modasalvador7435 thank you! I appreciate your support!

@@margintrader26 Hi there. Whatever is left to patient responsibility (per the insurance adjudication) should be billed to the patient from the practice. The way that happens depends on your billing situation and if the billing company generates these for you, or if your clearinghouse does it, or if you need to do it. There are a few different possibilities, but you’ll also need to know who is responsible for following up on collecting from the patient if they don’t pay in a timely manner- the practice or the billing company. Again, could be multiple options depending on your situation. Good luck and thanks for watching!

You are so kind and thank you for your support!! Be well!

Thank you for watching and how exciting. I wish you luck getting back into the field. Here is the link to my blog posts on my website that may assist you with getting your feet wet again. integralclinicsolutions.com/blog/ I appreciate your support of my channel!

Glad it was helpful! I appreciate you supporting my channel!

This is definitely a touch situation. I would suggest trying to contact their emergency contact and let them know you are having trouble contacting the patient and ask if they would contact them and have them call the office. You can also confirm the contact information you are using. Sending certified letters to the patient's home, or using electronic communication like a patient portal is another avenue to try. Although it can be life-threatening or very serious, you still have to be very careful in the information you divulge and to whom so you don't violate any laws. Great question and thanks so much for watching!

I appreciate you watching and for the comment!

I appreciate that so much! Thank you for watching!

Thank you for the suggestion. I will do some research into this platform to see if I can start offering them here as well. I appreciate you watching!

I will look into this. Thank you.

Thanks for watching. I'm glad you found it helpful

@@StandforAll you’re very welcome! Thank you for watching.

Hi there and thank you for watching! I apologize if I misspoke in that video. That is not true and you can be affiliated with as many groups as you’d like. When claims are processed and you’re the rendering provider on a claim, they insurance company checks to make sure your individual NPI (NPI 1) is affiliated with the billing group’s EIN and group NPI (NPI 2). That is how one provider can have multiple employers at once and not affect the other employers processing of claims. I hope this helps and good luck!!

@@jessicagonzales3841 oh good for you! Sounds like you like challenges and they need people like you. Good luck and thank you for supporting my channel!

Most welcome! Thanks for watching!

@@ronicaleggett929 hi there again. Group practices do not obtain licenses for practicing medicine. Those are only given to physicians as individuals. I hope this helps.

@@ronicaleggett929 hi and thank you for watching. This program is strictly for physicians only and no other providers, including NPs and PAs.

Hi there! Thank you for watching and you’re so welcome. I’m not super well-versed in DME but I’m happy to try. Jennifer@icsolns.net.

I’m so happy to hear you find the information helpful! Good for you to be self-taught! It’s not easy. I appreciate you supporting my channel. Be well.

Absolutely! I’m happy to do that for you. I will be recording videos this coming weekend for the next 3 weeks so keep your eye out! Thanks for watching and the request!!

@@taylordmadeva3757 thank you! I love to learn and teach. I appreciate you support my channel!

@@zahoorminhas thank you for your input. Commercial payers are not this easy, but I do have many videos on credentialing and contracting that will discuss this at length. Please check those out. I have playlists to help you find them. Thank you!

@@yosefnathan8648 thank you for watching!

I’m happy this was helpful! Good luck and thank you for supporting me and my channel!

Cover My Meds does let you apply online and they interface with many EMR systems too. It’s a wonderful tool especially for making sure specific needed information is submitted for specific meds and payers. Thanks for watching!

@@navigatingthebusinessofmed8251 thank you so much! Do you know why for some medications on CMM information is auto populated and there seems to be extra support vs others are hard to track? Have you experienced this?

I’m not exactly sure but I think it has something to do with their system and what they know is always required for specific meds and insurances. When they aren’t sure, they leave it blank. Just remember the basics that are always needed (tried and failed drugs, why they failed, how long they tried them for, if they’re on any contraindicated meds, etc.) and then you’ll also learn what drugs also need other information from doing it. I know that’s how I learned.

Glad you found the video helpful. Thanks for watching!

Hi there. Thank you for watching. Are you asking about where to submit a claim? I’m not sure which form you’re referring to. Change Healthcare is a clearinghouse and should be able to submit the claim to Medicare for you because Medicare only accepts electronic claims. Most billing software uses a clearinghouse for this purpose. I hope this helps and if not, please provide more specifics on the CMS form in which you’re referring.

@@mpizzle13 thank you so much! I appreciate the kind words and support of my channel! Be well!

Please email me jennifer@icsolns.net

Thanks for watching!

Thank you for watching!

Good morning and thank you for watching! Providers and groups (both) need to be enrolled with Medicare in each state they wish to practice and serve Medicare beneficiaries. This is the credentialing and contract process for Medicare. It can all be done through PECOS for groups/organizations and individual providers. Good luck!

@@navigatingthebusinessofmed8251 thank you so much!

Not that I’m aware of honestly. I recommend using Google to see what you can find. It’s a good starting point. Also, if you have colleagues who work in other offices, you can ask them too. Good luck and I appreciate you watching!

Hi there and thank you for asking. You would have to find which IPAs are in your area and then find on their website where to enroll/apply. I am sorry I cannot be more specific, but every area is different and all IPAs require different processes. Good luck!

Yes, this is true. However, many offices still require peer-to-peer referrals from their PCP, just for their records. Many will not schedule until it is received. It is a practice-preference for PPO's, but no one should assume a patient does not need a referral if they have a PPO. So many things are changing. Thanks for watching and for commenting!

@@zahoorminhas hi and thank you for watching. I’m sorry to hear or these challenges. I would make sure the doctor is logging into the correct I&A portal, if you have not already. If so, perhaps ask the doctor to log-in to her I&A portal and search your name to add you as a surrogate. That would be her initiating it and you logging into yours to confirm the access. I have found this to be easier when I’ve been in the same situation. I also try to sit with the provider when they log-in, or do a zoom meeting with a screen share to assist where needed. I hope this helps and good luck!

@@navigatingthebusinessofmed8251 thank you so much Jennifer. This will help me.

Hi there and sorry for the delay. The original charge for 99213 was $180 and the primary insurance did a $60 adjustment leaving $120 difference. The primary insurance applied that entire balance to the patient. Since they have a secondary insurance that patient balance then gets forwarded to the secondary insurance to see if they will pay anything too. Unless the primary insurance is Medicare, then a billing company would actually have to forward the claim balance to the secondary insurance and include the primary insurance EOB so they can see how the primary insurance paid. If it is a Medicare primary most of the time they will forward the claim to the secondary insurance as a courtesy, but it is not the primary billing the secondary. Primary and second insurances don’t bill one another, they just process in sequence. So now the secondary looks at that balance on 99213 to see if the primary paid more than they would have or if there is still some room for them to also pay and they process from there. I hope that makes sense. Good luck and thank you for watching!!