Medicare Small provider question

[Guest guest]

FYI regarding small provider waivers from electronic billing...no , one does not have to be under five foot tall to be considered a "small provider"......

J. Holzapfel, DCAlbany, Oregon

---------- Forwarded Message ----------From: CAC@...To: CAC@...; Subject: Fw: Small provider questionDate: Wed, 25 Jan 2012 13:11:39 -0500

From: KATHY BOEHM Sent: Wednesday, January 25, 2012 9:26 AM'sides@...'Cc: BECKE TURNERSubject: Small provider question

Dr. Sides, I have attached a hyperlink to a CMS document that defines a small provider for purposes of being exempt from mandatory submission of electronic claims. Each Medicare contractor identifies small providers in their own designated way. Some send letters to paper submitters and ask them to verify through a waiver process that they are a small provider and based on the response update their files. Other Medicare contractors in other states may require that providers initiate the request to be classified as a small provider and may use a process such as mentioned in the Oregon providerÂ’s email. CMS instructions require that all Medicare contractors take efforts to identify small providers for this reason.

The phone number listed in the Oregon providerÂ’s email rings to the EDI technology support department so it would appear that the Oregon Medicare contractor is asking small providers to contact their EDI department to start the process of registering as a small provider for purposes of exempting them as a small provider from mandatory electronic claim submission. This may not be the practice that every Medicare contractor across the country is using to identify small providers. I would have to suggest that chiropractors contact their own individual Medicare contractor to verify their specific processes as they are likely not the same and one process canÂ’t be applied nationally.

https://www.cms.gov/EducationMaterials/Downloads/Areyouacoveredentity-2.pdf

Sincerely,

Kathy Boehm

Provider Outreach and Education

Palmetto GBA, J11 MAC

Kathy BoehmOutreach and Education Representative

Palmetto GBA J11 MAC

(804) 440-8366

All inquires unrelated to Outreach and Education must be directed to the Provider Contact Center where there are dedicated resources to assist you.

www.PalmettoGBA.com/disclaimer

From: Sides [mailto:sides@...] Sent: Wednesday, January 25, 2012 7:13 AMBECKE TURNERSubject: Fw: Medicare EDI waiver center info

Becke, I just received this e-mail form the CAC rep in Oregon. Do you know if this is true? Is it required for a small Chiropractic office to register with the EDI Waiver Center to be exempt from electronic billing? Ricky Sides, DC

Medicare EDI waiver center info

Forwarded is a message from one of our colleagues. Any comment? This is the first I have heard this...

J. Holzapfel, DCAlbany, Oregon

---------- Forwarded Message ----------Date: Tue, 24 Jan 2012 18:47:01 -0500 (EST)

Hi everyone,

We heard a new one today from Medicare. Maybe this isn't new to anyone else, but here goes:

If you're a small business, you're exempt from electronic billing. ok we all knew this.

Did you know that you aren't exempt, UNLESS you call the EDI Waiver Center (800) 967-7902 and register as a 'small business exempt from e-billing' ?

[Guest guest]

I've been calling at different hours since Tuesday. Even called them at opening time 6 am yesterday and the call center has been too busy to accept calls -- they didn't even put me on hold. So, interesting that the government has created a catch 22 where we have to call in but can't get through!

Christian Mathisen, D.C., CCWFN

3654 S Pacific Hwy

Medford, Oregon, 97501

cmathdc@...

Medicare EDI waiver center info

Forwarded is a message from one of our colleagues. Any comment? This is the first I have heard this...

J. Holzapfel, DCAlbany, Oregon

---------- Forwarded Message ----------Date: Tue, 24 Jan 2012 18:47:01 -0500 (EST)

Hi everyone,

We heard a new one today from Medicare. Maybe this isn't new to anyone else, but here goes:

If you're a small business, you're exempt from electronic billing. ok we all knew this.

Did you know that you aren't exempt, UNLESS you call the EDI Waiver Center (800) 967-7902 and register as a 'small business exempt from e-billing' ?