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YOUR QUESTIONS ANSWERED


Question 1:

Is this allowed to bill a patient for services related to a Workers Compensation injury, in cases patient visited several Physical Therapy offices on the same day and our office got a denial as maximum allowable per patient/per day has already been reimbursed?

Answer:

Response from NYS Workers’ Compensation Board

The carrier should have filed a denial to the case folder, in which case the Judge should rule on the bill and determine if it is the claimant’s responsibility. You can send a letter to the Board stating you were unaware he was receiving PT at another facility if that is the case.
Methods for submitting documents to the Board are listed below; please be sure to click the links for instructions to ensure the documentation is placed in the case folder.

Please include the WCB Case Number on each page.

1. Email: wcbclaimsfiling@wcb.ny.gov  Email Filing Of Claim Documents
2. Mail: NYS Workers’ Compensation Board
Centralized Mailing Address
PO Box 5205
Binghamton, NY 13902-520
3. Fax: (877) 533-0337
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Question 2:

How to locate a new Medicare ID if the patient states that they did not receive it?

Answer:

Response provided by Maria Chechina, CPC, CMRS

Starting January 1st of 2020, the new Medicare ID must be used for eligibility verification and billing regardless of the date of service. If your patients do not bring their Medicare cards with them:
• Give them the Get Your New Medicare Card flyer in English (PDF) or Spanish (PDF).
• Use your Medicare Administrative Contractor’s look-up tool. For example, NGS Connex web portal for New York Medicare Part B providers. Use the full list of Medicare Administrative Contractors (MACs) Provider Portals (PDF) to find yours.
• For the New York State patients with Medicaid, the ePACES Medicaid web portal also can be used.

The new Medicare ID format
The new Medicare ID contains 11 characters with numbers 0-9 and all uppercase letters except for S, L, O, I, B, and Z.
For more details, please review the MBI specifications format.

Insights
September 2019