GOVERNMENTMedicare carrier switch: Who will pay you next?Contractor reform could mean that physicians will see big changes beginning next year in the companies processing their Medicare claims.By Markian Hawryluk, amednews staff. June 7, 2004. Change is never easy, as physicians in Rhode Island can attest. Late last year, the Medicare Part B carrier for the state, Blue Cross & Blue Shield of Rhode Island, announced that it no longer would process claims for the government. By February 2004, all Medicare claims would have to go to Arkansas Blue Cross and Blue Shield. At the same time, a problem arose with non-Medicare claims processing. Rhode Island Blues lost its license to provide technical support for some 250 physician practices using WebMD's billing software, Medical Manager. "It created a big, big mess because [the plan] had a large client base that was essentially left high and dry needing programming changes for the Medicare claims, as well as for all their billing related to HIPAA," said Yul Ejnes, MD, an internist from Cranston, R.I. "It created a major cash flow problem that people are still digging out of." Eventually WebMD agreed to extend the license for 90 days to help with the transition. But another software snafu left thousands of Medicare claims undelivered to the Arkansas Blues plan. Many practices suddenly saw revenue streams dry up. Some physicians had to forgo paychecks or dip into lines of credit until payments resumed. "We were stuck for a month and a half, two months, with no Medicare dollars coming in," said Scott Hanson, MD, an internist in Narragansett, R.I. About 20% of his practice's revenues come from Medicare. Rhode Island Blues had been with the program since 1966, the year after Medicare's passage. And while the shift to another carrier alone might not have caused the disruption that occurred, the timing could not have been worse. [...]Full text of American Medical News content is available to AMA members and paid subscribers.
Copyright 2004 American Medical Association. All rights reserved.
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