Re: Medicare Revalidation issues

[Guest guest]

I have not had that troubleI have my own troubles over here thsi week making me want to close up and go home foreverFailing that if you are dealing with you r carrier you may get stuck in the bureaucracy I went through this for  5 mo  for meaningful use

Attached is document with regional CMS contacts TRY that That is how I solved my probelm Forget the carriers you need someone higher up If yours  is like mine the contact was intelligent kind and usefulif you cannot get the  attachment  google cms regional offices

Jean

 

Warning!!! Start of rant.....................

I am wondering if anyone else has had these issues.

I started the Medicare revalidation process back in Novemeber 2011.

Of course sometime in january-feb it came back that it was missing some information. All calls to the Medicare center for help were un-returned until the day the corrections were due, which of course made it too late to resubmit.

So I copy over the previous application and correct the areas they questioned. In the meantime, Medicare as of March 1, 2012, cuts me off from paying claims. So I am essentially seeing Medicare patients and hoping that the revalidation process works it way thorugh, and then maybe I will get a big check with many months of payments all lumped together.

Well, then yesterday I get an email, this time telling me that there are other issues not mentioned previously, and that I now need a group npi number, even though I am the sole owner and operator of a corporation. Once I get this new group npi number I have to have it assigned to my practice and then resubmit the application.

All in all, that means at least another 2 months before I will know the status.

Essentially I feel trapped in bureaucracy, just like when I used to contract with other insurers. This was the main reason I dumped the other insurers, and it is why I am 95% certain I will be dumping Medicare and opting out by July 1st.

Has anyone else had these issues?

Oh and my meaningful use check/funds, which was submitted over 2 months ago has still not arrived. Calls to my Hi-Tech rep who helped with the submission have not been returned.

I am going back to the old way of doing business as a doctor.

Direct contracting with each patient.

It will be simpler, and each patient who comes to my office will want to be there!

End of rant.................

Horvitz, D.O.

Founder of the Institute for Medical Wellness

stown, NJ

--      MD          ph    fax

1 of 1 File(s)

Regional_Point_Of_Contacts_10-12-10.pdf

[Guest guest]

Grace,What was the holdup?  Did they tell you?  Did you fill out the 855b and update PECOS at the same time?  I was told  to do it 30 days before we move, although I was planning to do it Monday, which is about 55 days prior to our July 1 move.  Palmetto is our carrier.

Thanks, Pratt

 

I started the process of changing my address with Medicare a full 2 months before I moved down the hall. I went without any payment for medicare for a full 3 months after my move until they fixed the issue after about 50 correspondences. It could not have been anymore painful to have about 20% of my revenue disappear after the costs of the move.

g

To: Sent: Friday, May 4, 2012 11:01 AM

Subject: Medicare Revalidation issues

 

Warning!!! Start of rant.....................I am wondering if anyone else has had these issues.I started the Medicare revalidation process back in Novemeber 2011.

Of course sometime in january-feb it came back that it was missing some information. All calls to the Medicare center for help were un-returned until the day the corrections were due, which of course made it too late to resubmit.

So I copy over the previous application and correct the areas they questioned. In the meantime, Medicare as of March 1, 2012, cuts me off from paying claims. So I am essentially seeing Medicare patients and hoping that the revalidation process works it way thorugh, and then

maybe I will get a big check with many months of payments all lumped together.Well, then yesterday I get an email, this time telling me that there are other issues not mentioned previously, and that I now need a group npi number, even though I am the sole owner and operator of a corporation. Once I get this new group npi number I have to have it assigned to my practice and then resubmit the application.

All in all, that means at least another 2 months before I will know the status.Essentially I feel trapped in bureaucracy, just like when I used to contract with other insurers. This was the main reason I dumped the other insurers, and it is why I am 95% certain I will be dumping Medicare and opting out by July 1st.

Has anyone else had these issues?Oh and my meaningful use check/funds, which was submitted over 2 months ago has still not

arrived. Calls to my Hi-Tech rep who helped with the submission have not been returned.I am going back to the old way of doing business as a doctor.Direct contracting with each patient.It will be simpler, and each patient who comes to my office will want to be there!

End of rant................. Horvitz, D.O.Founder of the Institute for Medical Wellnessstown, NJ

[Guest guest]

Of course, that's why my IMP has NEVER taken Medicare or medicaid, it is impossible to deal with them.

Why are you still seeing, I don't they will retro the claims, you are just giving your service away.

CCote

To: Sent: Friday, May 4, 2012 10:01:22 AMSubject: Medicare Revalidation issues

Warning!!! Start of rant.....................I am wondering if anyone else has had these issues.I started the Medicare revalidation process back in Novemeber 2011.Of course sometime in january-feb it came back that it was missing some information. All calls to the Medicare center for help were un-returned until the day the corrections were due, which of course made it too late to resubmit.So I copy over the previous application and correct the areas they questioned. In the meantime, Medicare as of March 1, 2012, cuts me off from paying claims. So I am essentially seeing Medicare patients and hoping that the revalidation process works it way thorugh, and then maybe I will get a big check with many months of payments all lumped together.Well, then yesterday I get an email, this time telling me that there are other issues not mentioned previously, and that I now need a group npi number, even though I am the sole owner and operator of a corporation. Once I get this new group npi number I have to have it assigned to my practice and then resubmit the application.All in all, that means at least another 2 months before I will know the status.Essentially I feel trapped in bureaucracy, just like when I used to contract with other insurers. This was the main reason I dumped the other insurers, and it is why I am 95% certain I will be dumping Medicare and opting out by July 1st. Has anyone else had these issues?Oh and my meaningful use check/funds, which was submitted over 2 months ago has still not arrived. Calls to my Hi-Tech rep who helped with the submission have not been returned.I am going back to the old way of doing business as a doctor.Direct contracting with each patient.It will be simpler, and each patient who comes to my office will want to be there!End of rant................. Horvitz, D.O.Founder of the Institute for Medical Wellnessstown, NJ

[Guest guest]

,I had similar issues with PECOS and Medicare and being a sole-proprietor of an LLC. I had to submit some extra forms from the IRS saying that I would not be submitting taxes under that Tax ID number. NJ is special. I did get useful help from the PECOS people by phone and less by e-mail once I got to the right people. It was a hassle. Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of drhorvitzSent: Friday, May 04, 2012 1:01 PMTo: Subject: Medicare Revalidation issues Warning!!! Start of rant.....................I am wondering if anyone else has had these issues.I started the Medicare revalidation process back in Novemeber 2011.Of course sometime in january-feb it came back that it was missing some information. All calls to the Medicare center for help were un-returned until the day the corrections were due, which of course made it too late to resubmit.So I copy over the previous application and correct the areas they questioned. In the meantime, Medicare as of March 1, 2012, cuts me off from paying claims. So I am essentially seeing Medicare patients and hoping that the revalidation process works it way thorugh, and then maybe I will get a big check with many months of payments all lumped together.Well, then yesterday I get an email, this time telling me that there are other issues not mentioned previously, and that I now need a group npi number, even though I am the sole owner and operator of a corporation. Once I get this new group npi number I have to have it assigned to my practice and then resubmit the application.All in all, that means at least another 2 months before I will know the status.Essentially I feel trapped in bureaucracy, just like when I used to contract with other insurers. This was the main reason I dumped the other insurers, and it is why I am 95% certain I will be dumping Medicare and opting out by July 1st. Has anyone else had these issues?Oh and my meaningful use check/funds, which was submitted over 2 months ago has still not arrived. Calls to my Hi-Tech rep who helped with the submission have not been returned.I am going back to the old way of doing business as a doctor.Direct contracting with each patient.It will be simpler, and each patient who comes to my office will want to be there!End of rant................. Horvitz, D.O.Founder of the Institute for Medical Wellnessstown, NJ

[Guest guest]

When we moved to another location it took an entire year!!! We went unpaid for the whole year but did receive a lump sum payment when Medicare finally stopped losing bits and pieces of the paperwork. They finally admitted in the end that they split these forms up and give different people parts of the form to input. Every time there was an issue we had to resend the entire form again. They just continued losing portions of the form. We are not the only ones that I have heard of that has had to wait up to a year for them to get it together. Go as far to the top as you can and try to only work with one individual. Michele To: Sent: Friday, May 4, 2012 11:45 AM Subject: Re: Medicare Revalidation issues

Of course, that's why my IMP has NEVER taken Medicare or medicaid, it is impossible to deal with them.

Why are you still seeing, I don't they will retro the claims, you are just giving your service away.

CCote

To: Sent: Friday, May 4, 2012 10:01:22 AMSubject: Medicare Revalidation issues

Warning!!! Start of rant.....................I am wondering if anyone else has had these issues.I started the Medicare revalidation process back in Novemeber 2011.Of course sometime in january-feb it came back that it was missing some information. All calls to the Medicare center for help were un-returned until the day the corrections were due, which of course made it too late to resubmit.So I copy over the previous application and correct the areas they questioned. In the meantime, Medicare as of March 1, 2012, cuts me off from paying claims. So I am essentially seeing Medicare patients and hoping that the revalidation process works it way thorugh, and then maybe I will get a big check with many months of payments all lumped together.Well, then yesterday I get an email, this time telling me that there are other issues not mentioned previously, and that I now need a group npi number, even though I am the sole

owner and operator of a corporation. Once I get this new group npi number I have to have it assigned to my practice and then resubmit the application.All in all, that means at least another 2 months before I will know the status.Essentially I feel trapped in bureaucracy, just like when I used to contract with other insurers. This was the main reason I dumped the other insurers, and it is why I am 95% certain I will be dumping Medicare and opting out by July 1st. Has anyone else had these issues?Oh and my meaningful use check/funds, which was submitted over 2 months ago has still not arrived. Calls to my Hi-Tech rep who helped with the submission have not been returned.I am going back to the old way of doing business as a doctor.Direct contracting with each patient.It will be simpler, and each patient who comes to my office will want to be there!End of rant.................

Horvitz, D.O.Founder of the Institute for Medical Wellnessstown, NJ

[Guest guest]

I tried to submitt mine early and it was sent back and told to resubmitte 30 days before opening the practice, no earlier! Hope your carrier is more reasonable. To: " "

< > Sent: Friday, May 4, 2012 2:40 PM Subject: Re: Medicare Revalidation issues

Grace,What was the holdup? Did they tell you? Did you fill out the 855b and update PECOS at the same time? I was told to do it 30 days before we move, although I was planning to do it Monday, which is about 55 days prior to our July 1 move. Palmetto is our carrier.

Thanks, Pratt

I started the process of changing my address with Medicare a full 2 months before I moved down the hall. I went without any payment for medicare for a full 3 months after my move until they fixed the issue after about 50 correspondences. It could not have been anymore painful to have about 20% of my revenue disappear after the costs of the move.

g

To: Sent: Friday, May 4, 2012 11:01 AM

Subject: Medicare Revalidation issues

Warning!!! Start of rant.....................I am wondering if anyone else has had these issues.I started the Medicare revalidation process back in Novemeber 2011.

Of course sometime in january-feb it came back that it was missing some information. All calls to the Medicare center for help were un-returned until the day the corrections were due, which of course made it too late to resubmit.

So I copy over the previous application and correct the areas they questioned. In the meantime, Medicare as of March 1, 2012, cuts me off from paying claims. So I am essentially seeing Medicare patients and hoping that the revalidation process works it way thorugh, and then

maybe I will get a big check with many months of payments all lumped together.Well, then yesterday I get an email, this time telling me that there are other issues not mentioned previously, and that I now need a group npi number, even though I am the sole owner and operator of a corporation. Once I get this new group npi number I have to have it assigned to my practice and then resubmit the application.

All in all, that means at least another 2 months before I will know the status.Essentially I feel trapped in bureaucracy, just like when I used to contract with other insurers. This was the main reason I dumped the other insurers, and it is why I am 95% certain I will be dumping Medicare and opting out by July 1st.

Has anyone else had these issues?Oh and my meaningful use check/funds, which was submitted over 2 months ago has still not

arrived. Calls to my Hi-Tech rep who helped with the submission have not been returned.I am going back to the old way of doing business as a doctor.Direct contracting with each patient.It will be simpler, and each patient who comes to my office will want to be there!

End of rant................. Horvitz, D.O.Founder of the Institute for Medical Wellnessstown, NJ

[Guest guest]

Have had the same problems. One 3-4 month delay in payments

when I changed addresses, moving only 2 doors down the street.

Then another 3-4 month delay the same year when they started using the NPI

numbers. I had

gotten out of a group a couple of years before, but somehow their

" crosswalk " program still had me listed in the old group. It took a

long time to straighten that out, and payments stopped. They do

pay you retroactively for the patients you are seeing during these

downtimes, so be sure you are creating the claims. I had another recent 2 1/2

month delay this year when the billing intermediary I used called MdOn-line

which is similar to OfficeAlly changed the big mega electronic clearinghouse

they submit to. You have to be registered with the

big mega electronic clearinghouse in order to submit electronic claims to

Medicare, and even

though I was OK with Medicare itself and the old EDI clearinghouse,

I had to fill out a whole new application for the new EDI clearinghouse. Still

got paid for all the claims eventually, but payment was delayed until they were

satisfied.

Caldwell

Tulare, CA

>

> Warning!!! Start of rant.....................

>

> I am wondering if anyone else has had these issues.

>

> I started the Medicare revalidation process back in Novemeber 2011.

> Of course sometime in january-feb it came back that it was missing some

information. All calls to the Medicare center for help were un-returned until

the day the corrections were due, which of course made it too late to resubmit.

>

> So I copy over the previous application and correct the areas they questioned.

In the meantime, Medicare as of March 1, 2012, cuts me off from paying claims.

So I am essentially seeing Medicare patients and hoping that the revalidation

process works it way thorugh, and then maybe I will get a big check with many

months of payments all lumped together.

>

> Well, then yesterday I get an email, this time telling me that there are other

issues not mentioned previously, and that I now need a group npi number, even

though I am the sole owner and operator of a corporation. Once I get this new

group npi number I have to have it assigned to my practice and then resubmit the

application.

>

> All in all, that means at least another 2 months before I will know the

status.

>

> Essentially I feel trapped in bureaucracy, just like when I used to contract

with other insurers. This was the main reason I dumped the other insurers, and

it is why I am 95% certain I will be dumping Medicare and opting out by July

1st.

>

> Has anyone else had these issues?

>

> Oh and my meaningful use check/funds, which was submitted over 2 months ago

has still not arrived. Calls to my Hi-Tech rep who helped with the submission

have not been returned.

>

> I am going back to the old way of doing business as a doctor.

>

> Direct contracting with each patient.

>

> It will be simpler, and each patient who comes to my office will want to be

there!

>

> End of rant.................

>

> Horvitz, D.O.

> Founder of the Institute for Medical Wellness

> stown, NJ

>

[Guest guest]

Kathy, how do you get in touch with the PECOS people?Lonna To: Sent: Friday, May 4, 2012 11:57 AM Subject: RE: Medicare Revalidation issues

,I had similar issues with PECOS and Medicare and being a sole-proprietor of an LLC. I had to submit some extra forms from the IRS saying that I would not be submitting taxes under that Tax ID number. NJ is special. I did get useful help from the PECOS people by phone and less by e-mail once I got to the right people. It was a hassle. Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of drhorvitzSent: Friday, May 04, 2012 1:01 PMTo: Subject: Medicare Revalidation issues Warning!!! Start of rant.....................I am wondering if anyone else has had these issues.I started the Medicare revalidation process back in Novemeber 2011.Of course sometime in january-feb it came back that it was missing some information. All calls to the Medicare center for help were un-returned until the day the

corrections were due, which of course made it too late to resubmit.So I copy over the previous application and correct the areas they questioned. In the meantime, Medicare as of March 1, 2012, cuts me off from paying claims. So I am essentially seeing Medicare patients and hoping that the revalidation process works it way thorugh, and then maybe I will get a big check with many months of payments all lumped together.Well, then yesterday I get an email, this time telling me that there are other issues not mentioned previously, and that I now need a group npi number, even though I am the sole owner and operator of a corporation. Once I get this new group npi number I have to have it assigned to my practice and then resubmit the application.All in all, that means at least another 2 months before I will know the status.Essentially I feel trapped in bureaucracy, just like when I used to contract with other insurers. This was

the main reason I dumped the other insurers, and it is why I am 95% certain I will be dumping Medicare and opting out by July 1st. Has anyone else had these issues?Oh and my meaningful use check/funds, which was submitted over 2 months ago has still not arrived. Calls to my Hi-Tech rep who helped with the submission have not been returned.I am going back to the old way of doing business as a doctor.Direct contracting with each patient.It will be simpler, and each patient who comes to my office will want to be there!End of rant................. Horvitz, D.O.Founder of the Institute for Medical Wellnessstown, NJ