Sunday, August 14, 2011

Getting pricing option on Medicare IVR

DME MAC A IVR User Guide - Pricing Options

Pricing - Option 6 


When pricing is selected, the IVR will request the following elements:

• National Provider Identifier (NPI)
• PTAN (10-digit supplier number)
• Last 5 digits of the Tax Identification Number (TIN)
• HCPCS code
• HCPCS modifier (if none, say “no modifier”)
• State

Once the authentication elements have been verified, the IVR will supply the following:

• Allowed amount from the provider fee schedule

For pricing navigation options, refer to the following:
                                             Pricing Navigation
Voice                                                Touch-Tone Entry
Repeat That                                                      1
Change HCPCS                                               2
Change Modifier                                               3
Change State                                                    4
Main Menu                                                       5
Labels:

0 comments:

Post a Comment

Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download