medicare billing

core0 · Jul 6, 2009

Hi,
I am a new NP and have filed my Medicare application. I'm the first NP that my practice has ever hired. Can anyone tell me how long it takes for the application to be approved and start seeing patients?

From CMS:

CMS estimates that the processing time for paper applications will be approximately 20 calendar days.

The resulting NPIs from Web applications will be e-mailed to the designated contact person within five calendar days.

Hopefully you did the web app;).

David Carpenter, PA-C

NHRNmomof3 · Jul 14, 2009

Thanks,

I did do the online application. I got a tracking number. I wast told that the goal was 60 days or processing, but could take up to 90 or even 180 days. My understanding is that I can bill back from 30 days before the application was submitted. Is this correct? But that could mean my bills are held onto for 6 months before submitting. This is a long time. I've read about and heard about incident to billing. Can someone please explain this to me.

core0 · Jul 15, 2009

Thanks,
I did do the online application. I got a tracking number. I wast told that the goal was 60 days or processing, but could take up to 90 or even 180 days. My understanding is that I can bill back from 30 days before the application was submitted. Is this correct? But that could mean my bills are held onto for 6 months before submitting. This is a long time. I've read about and heard about incident to billing. Can someone please explain this to me.

I got my NPI in about three days, although I already had a Medicare number. According to their website it should only take around 10 days. I think that the processing refers to processing Medicare claims. When I started I was told that it takes around 60 days before you start seeing payment for your first Medicare claim. With all the fraud they may be taking longer but I would be suprised if it took 60 days.

David Carpenter, PA-C

NHRNmomof3 · Jul 15, 2009

Well that sounds encouraging. I will call again later tomorrow or have the office call to make sure things are moving along.

NHRNmomof3 · Sep 3, 2009

Dave,

I can't tell you how frustrated I am with this processs. I am now on my second medicare application. They gave me wrong info that caused my application to be closed. This took 6 weeks. I was told there was nothing that could be done about it and I had to reapply. I am just devastated. I'm now almost 2 weeks in the process and it is still in screening. I'm getting now where when I call, but I don't want to jeopardize my approval, but I don't feel like there is any justice to this system. It's been 3 months since I passed my exam and everything, but this has occured smoothly. My employer won't let me start until I'm Medicare credentialed, which I can completely understand, but this is so draining. Sorry I just really needed to vent.

agagern · Sep 4, 2009

Not to be funny....but probably a year and a day.

core0 · Sep 4, 2009

Dave,
I can't tell you how frustrated I am with this processs. I am now on my second medicare application. They gave me wrong info that caused my application to be closed. This took 6 weeks. I was told there was nothing that could be done about it and I had to reapply. I am just devastated. I'm now almost 2 weeks in the process and it is still in screening. I'm getting now where when I call, but I don't want to jeopardize my approval, but I don't feel like there is any justice to this system. It's been 3 months since I passed my exam and everything, but this has occured smoothly. My employer won't let me start until I'm Medicare credentialed, which I can completely understand, but this is so draining. Sorry I just really needed to vent.

Do they have anyone helping you? As you are finding out this is a very complex process which does not reward mistakes. Everywhere I've worked had someone that did all of the credentialing with insurance companies. Its usually somebody in billing that understands all the ins and outs of the insurance business. All I did was give them the information and everything came back a few days later. Ask the practice if they have someone that can help you since its obviously in their best interest for you to start seeing patients and submit bills.

David Carpenter, PA-C

NHRNmomof3 · Sep 4, 2009

Dave,

Thanks. the office manager adn I have been doing it together. We've called our carrier, NHIC to answer our questions. Now we find out the answers we were given were wrong and jeopardize my application to the point it was closed and had to start over. If this ever gets approved, I'll be the second provider to this practice. The owner is the other. So this is the second time the practice has had to do this. Yesterday I was told it was still in screening. It's been almost two weeks. I'll keep my fingers crossed. I was told this time that the paperwork that I sent in looked completely it was a matter of processing everything. We'll see how this goes. Thanks for listening.

BarbaraNP · Sep 6, 2009

Of all the applications I ever had to do, Medicare was perhaps the most frustrating. It can take 90-120 days to get your Medicare #.

The good news is that you begin to see patients and hold the bills until the numbers come through.

BarbaraNP

NHRNmomof3 · Sep 16, 2009

Good news. I've been approved. 3 weeks after the start of the second application.