RE: Medicare Billing

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From:"Weems, Joyce" <> (by way of histonet)
To:histonet <>
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Hi Margarie and all!
I have been mulling over this billing thing for over a year and am still
confused!!! I have asked our legal department about it and they are

Our biggest problem has been with consults, which is what I am trying to
change. If we send out consults and bill the patient from our
institution, we often incur more charges when the consulting pathologist
does additional  special stains or immunos. We then can not collect
those charges, because it has been too long past the date of service.
Now, granted, the biggest problem is with Medicare, (our census is ~65%
Medicare!), but insurance companies are also beginning investigations so
that everything is under scrutiny. The problem is that Medicare charges
FRAUD instead of error!

I am looking forward to what answers we are going to come with!


>From: 	Hagerty, Marjorie A.[]
>Sent: 	Monday, November 23, 1998 8:18 PM
>To: 	Histonet
>Subject: 	Medicare Billing
>Hi Everyone,
>After reading Joyce Weem's explanation concerning medicare billing
>requirements, I find myself very confused. I am, however, less confused than
>I was before I read it! I am beginning to think that I am making some
>illegal billing decisions. (Oh, no!)
>My question is this - Where can I find out more information on this? What
>can I read?
>Is anyone willing to explain this to me in a phone conversation? Joyce? Any
>billing experts?
>All help and direction will be greatly appreciated. I don't want all
>reference laboratories to bill us because I know we will lose money. I would
>like to have the reference laboratory bill whenever it is legal.
>Rancho Mirage, CA, USA

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