As it is so difficult to get someone on the phon at Medicare, I thought I would post here to see if anyone else has experienced this issue. We have had issues with billing for substance use disorder services in the last few months with PMAP policies that are secondary to Medicare. What most recently happended is that the client didn't inform us of a primary Medicare policy, and we found out about it after getting claim denials from the secondary BCBS MN PMAP policy.
Here is the issue: our facility and providers are not Medicare eligible - in fact in the past Medicare has told us that we cannot send claims to them; Medicare stated that patients would need pay us directly for services, and then send claims to Medicare themselves in order to get reimursed.
I'm at a loss at this point as to how to proceed with secondary claims to BCBS MN - I can't get a denial as I can't send claims, and BCBS MN won't pay without COB information.
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