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<blockquote data-quote="bhsmte" data-source="post: 68258024" data-attributes="member: 329816"><p>Let me tell you one experience, in dealing with Medicare.</p><p></p><p>I worked for a healthcare provider that saw mostly Medicare patients. We wanted to expand to a new state, which would require us to get a state license and after that, submit the location for Medicare approval. That is all fine, the government should make sure providers are meeting minimum standards for their patients.</p><p></p><p>Well, we got the state license and passed state regulations within a couple of months, we then went to an organization, which is considered the gold standard of certification in the healthcare arena (the Joint Commission) and paid there fees, because if we waited on the Medicare folks to visit our facility and do their review, it would have been a long wait. Medicare accepts Joint Commission certification and once we were approved by the Joint Commission, we could then just submit this certification to Medicare and get our provider number, so we could begin to bill Medicare for the services we provide.</p><p></p><p>Now, keep in mind, Medicare requires you to treat a certain amount of patients for a certain period of time (once the state approves you) before you can even have Joint Commission or Medicare come in for final approval, so they have test cases they can review. Also, keep in mind, we can't bill for these patients and we have to treat them for free, all while we are paying employees and paying for other expenses related to treating the patients.</p><p></p><p>So, we get approval from Joint Commission and submit our certification to Medicare, so we could get our number and starting billing and actually collecting money. Well, one month goes by and after several calls, Medicare finally calls back and says they have the certification and the number should be arriving within days. After another month and numerous calls, Medicare finally responds and says they are missing some information from our initial application and need it resent to them and I had sent this already to them, months prior, but they had lost it so I sent again. Another several weeks goes by and numerous calls unanswered and they finally respond and they say they are missing one other piece from the original application, but it is something different this time and this had already been sent to them months prior, because I kept a copy of everything that was sent to them. So I resend this information again and about a month after that and several calls, we finally get our number and are able to actually collect money, after treating patients for free, for about 6 months.</p><p></p><p>And, Medicare does not allow you to back bill for any patients, even when the review showed, we had treated them properly and were certified by the gold standard from Joint Commission.</p><p></p><p>All in all, it took Medicare several months to give us a simple number and they lost paperwork that had been sent to them months before and despite asking them if they had everything they needed and they replied yes, they would come back weeks later saying they were still missing something.</p><p></p><p>This wonderful display of efficiency, cost my company about $300,000 in lost revenue, which we could never recover.</p></blockquote><p></p>
[QUOTE="bhsmte, post: 68258024, member: 329816"] Let me tell you one experience, in dealing with Medicare. I worked for a healthcare provider that saw mostly Medicare patients. We wanted to expand to a new state, which would require us to get a state license and after that, submit the location for Medicare approval. That is all fine, the government should make sure providers are meeting minimum standards for their patients. Well, we got the state license and passed state regulations within a couple of months, we then went to an organization, which is considered the gold standard of certification in the healthcare arena (the Joint Commission) and paid there fees, because if we waited on the Medicare folks to visit our facility and do their review, it would have been a long wait. Medicare accepts Joint Commission certification and once we were approved by the Joint Commission, we could then just submit this certification to Medicare and get our provider number, so we could begin to bill Medicare for the services we provide. Now, keep in mind, Medicare requires you to treat a certain amount of patients for a certain period of time (once the state approves you) before you can even have Joint Commission or Medicare come in for final approval, so they have test cases they can review. Also, keep in mind, we can't bill for these patients and we have to treat them for free, all while we are paying employees and paying for other expenses related to treating the patients. So, we get approval from Joint Commission and submit our certification to Medicare, so we could get our number and starting billing and actually collecting money. Well, one month goes by and after several calls, Medicare finally calls back and says they have the certification and the number should be arriving within days. After another month and numerous calls, Medicare finally responds and says they are missing some information from our initial application and need it resent to them and I had sent this already to them, months prior, but they had lost it so I sent again. Another several weeks goes by and numerous calls unanswered and they finally respond and they say they are missing one other piece from the original application, but it is something different this time and this had already been sent to them months prior, because I kept a copy of everything that was sent to them. So I resend this information again and about a month after that and several calls, we finally get our number and are able to actually collect money, after treating patients for free, for about 6 months. And, Medicare does not allow you to back bill for any patients, even when the review showed, we had treated them properly and were certified by the gold standard from Joint Commission. All in all, it took Medicare several months to give us a simple number and they lost paperwork that had been sent to them months before and despite asking them if they had everything they needed and they replied yes, they would come back weeks later saying they were still missing something. This wonderful display of efficiency, cost my company about $300,000 in lost revenue, which we could never recover. [/QUOTE]
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