12/22/2020 - Holding Claims for Deductible

It is that time again to decide if you would like for EBS to hold your Medicare Part B (DME) claims for billing until after the typical deductible season has past, between the months of January 01, 2021 through March 31, 2021. 

Some providers choose to hold claims to avoid having to wrestle the money out of the hands of a little old lady; while others simply stand firm in demanding payment up front and file non-assigned claims (if they are a non-par provider) during these months.   Some patients may have co-insurance that will cover the deductible;  however some secondary payers (like AARP) have their own deductible that matches the Medicare deductible causing the balance to be paid by the patient.  Either way, deductible season will be here before you know it, and we have to decide. 

EBS has a script in place that can stop ALL Medicare Part B claims from transmitting for a defined period of time.  If you choose to have your claims held till March 31, 2021, you must send an email to mstoner@ebsservice.com as soon as possible.  On April 1, 2021 we will transmit all claims that have been held. 

Keep in mind that if you hold claims, it does not guarantee that they won't hit the deductible.  It is just expected and likely that patient's will have met their deductible elsewhere by this time.  I don't know that I really have a "strong" opinion either way.  However....as always....I do have an opinion and you don't have to ask to get it.  Personally, I believe that patients KNOW that the deductible has to be paid to someone....whether it is you, their physician or hospital, etc.  If at all possible...I would expect payment at the time of service and bill non-assigned claims for these months.  Having said that....you have to keep in mind that non-assigned is not an option if you are a participating provider, nor is it available for Medicare Part B prescription drugs, or dual eligible Medicare/Medicaid patients, and capped rental claims require a signed beneficiary authorization every month prior to billing non-assigned.

Remember, if you choose to have your claims held till March 31, 2021, you must send an email to mstoner@ebsservice.com as soon as possible. 
 
 
 


Electronic Billing Services, Inc
138 N Prairie St
Sikeston, MO  63801
Phone: (573) 472-3613
info@ebsservice.com
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