I am not a MCS Classicare participant provider, can I provide and bill services given to MCS Classicare PFFS (Private Fee for Services) affiliates?
One of our Classicare coverages, MCS Classicare PFFS, gives the affiliates the alternative of accessing services from providers outside our MCS Classicare network. If you are a traditional Medicare provider, you can provide and bill services given to this patients directly to MCS Classicare. In these cases, the provider has the right to decide, case by case and visit by visit, whether or not to provide services to an MCS Classicare PFFS affiliate. If you decide to provide the services, you are accepting MCS Classicare’s payment terms and conditions and should bill us directly based on Medicare’s fee schedule within your service area. Services should be billed no later than ninety (90) days from the date of service, according to the Prompt Payment Regulation. Invoices received after that date will not be considered valid for payment. In order to bill MCS Classicare, you should use the standard billing form CMS 1500 for professional services or the UB-04 for institutional services.
Related Questions
- I am not a MCS Classicare participant provider, can I provide and bill services given to MCS Classicare PFFS (Private Fee for Services) affiliates?
- Can a healthcare provider be reimbursed for indirect services? Do Medicare, Medicaid, or private insurance pay for indirect services?
- Are there cities that currently depend solely on a private provider for paramedic/ambulance transport services?
