Medicare Plus Blue Payment Errors

[Guest guest]

I wanted to take the time to give a shout out to Jim Hall at Rehab Management

Services.

Here in Michigan, Medicare Plus Blue was not paying according to CMS guidelines

for outpatient physical therapy services billing on a HCFA 1500. I still have no

idea how they errored on their payments to physical therapist providers. Of

course, the error benefited their bottom line.

Jim handles all the headaches of billing for me. When this issue arose, Jim

wrote a letter to a few different entities, one of which was Senator Debbie

Stabenow. I'm not sure what Stabenow's office did, but today I received a letter

from Medicare Plus Blue accepting responsibility for erroneous payments and

assurance the problem would be rectified so future claims would be processed

correctly. AND an actual check was received in a separate envelope today!

So, for those of you in Michigan - take a look at your claims processed by

Medicare Plus Blue. I have no idea if claims will be reprocessed without

Medicare Plus Blue being alerted. Also check your future claims. The error

occurred whenever 97110 was concurrently provided with a different procedural

code. I am under the assumption the error is to be corrected (although no

deadline as to when the correction would occur was provided).

Thank you, Jim... and all of Michigan should thank you too! You were absolutely

right in your opinion of how to tackle the problem AND you solved it in less

than 30 days! You rock!

Selena Horner, PT

ton, MI