What’s Happening at Medicare?

We used to hear others complain about Medicare and how they would not pay the claims right and how slow they could be and all these other problems they had with Medicare and we always disagreed. We always found Medicare to be quite straight forward and predictable.
That was until Sept 1, 2008 when it seems many Medicare offices changed carriers. We offer credentialing services to medical providers, so we are dealing with Medicare offices all over the country and have found a few areas where this transition didn’t go smoothly at all and our local carrier is one of them.
Under our old Medicare carrier you knew exactly what to expect. If you submitted claims electronically, payment would come in 14 days, 28 days on paper. When something was denied you would call customer service and they would explain to you exactly what was wrong and what you had to do to correct it. Now claims get “hung up in the system” for unexplainable reasons and for indefinite periods of time. Now when we get a denial that is completely wrong or unexplainable, we call customer service and they can’t answer any questions. They only refer you to the remit.
Now when claims are not paid on time or are denied incorrectly, there is little recourse for the provider. We expected things to get better over time but it has been five months since the transition and things are still completely tumultuous. We feel that it is time to contact our local congressman.

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