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Can you bill w/ authorization to CCTDF funding if client has medicare primary?

Jenna 2 years ago in Billing/Electronic Modules updated 2 years ago 6

We are not a medicare facility. We are wondering if anyone has successfully billed out CCDTF funding from the county when given service authorization if a patient has medicare primary? The counties are saying it "overrides" if they are giving a service authorization but we are getting a kick back due to other payer.  

We bypass Medicare completely when we bill CCDTF as Medicare doesn't recognize those codes.  

Oh they don't at all?! This is good to know. So you are able to enter service authorization number in and bill out residential codes without kick back? (sorry I didn't make that super specific in my original question) 

Yes we bypass Medicare all together.  If you are keying directly into MNITs you wouldn't enter the Medicare only enter as if it were primary.  If you are billing out of Procentive then have to manipulate to show CCDTF as primary. I key mine right into MNITs because otherwise it is too much of a pain to keep switching them back and forth.

Thank you Kelly! Have you billed a secondary PMAP plan if they give you SA. We get a kick back on this when we try to bill. Is there a way to bypass on this as well?

No I haven't found a way as of yet I ususally have to manipulate the insurance to show the PMAP as prime.  Very time consuming.

Thank you for your help!