Fwd: Provider Woes

[Grove...@aol.com]

Welcome to the world of no longer providing services for these 2 entities!
In 15 years I have never been paid, for a variety of crazy reasons on their
part, from ACS. Most recent excuse was my provider number was in the wrong
box so they couldn't send me a denial of payment because they couldn't find
my address to send it without this number in the right box and this was why
I was receiving the denial. Never mind that my address was on the claim in 3
separate places. Good luck.
Cynthia Sontag

>From: "toolspalette" <toolspalette@yahoo.com>
>Reply-To: NMhelpers@yahoogroups.com
>To: NMhelpers@yahoogroups.com
>Subject: [NMhelpers] Medicare Provider Woes
>Date: Tue, 24 Jul 2007 16:33:45 -0000
>
>For those few of you (social workers, psychologists) out there who are
>Medicare providers or who have dreamed of becoming one, perhaps you
>can appreciate this story about the difficulty of getting paid, and/or
>offer advice...
>
>I've been seeing two Medicare/Medicaid clients for about a year, and
>was submitting paper claims for direct deposit. Sure enough, some sums
>of money were eventually being deposited into my account from
>Medicare. However, I never received their "remittance advice" or any
>explanations of payment. This makes book-keeping difficult. When I
>called, they told me that the government was trying to save paper and
>hence the only way I could find out who/what they were paying me for
>would be if I had dial-up internet service. Like most of the world,
>at this point I had high-speed cable service and no telephone land
>line, but that didn't matter to them. It had to be dial-up only -- or
>there was absolutely no way to get EOPs or even information over the
>phone. Oh yes, they did finally say I could write to the "Freedom of
>Information" department where I could have the privilege of paying, in
>order to receive copies of information about the payments for my services.
>
>Fortunately, my biller has switched to electronic Medicare claim
>submission, and I recently received one EOP covering a few recent
>sessions. The past year's sessions remain a mystery.
>
>Part 2 of the story is that I finally called ACS Medicaid to follow up
>on why I hadn't been paid the "cross-over" amount (or copay). ACS had
>no record of Medicare having submitted any of the claims to them.
>However, they also told me I wasn't properly "set up for cross-over"
>and hence the claims would have simply bounced. Since I didn't have a
>record of when I had sent ACS my Medicare number, I was out of luck.
>They told me I had to re-do all the claims on paper, re-send them to
>Medicare, and wait till Medicare resubmitted them to Medicaid. Then
>I'd get paid the cross-over amount.
>
>This all seems incredibly time-consuming. Does anyone have any
>feedback or suggestions?
>
>Thanks,
>Beatrice Boles, LISW
>

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