Polaris-Strategic Solutions for Health Care

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Strategic Solutions
Part B Billing Management

The Polaris Group's Part B Billing Program offers a convenient, effective and accurate way for your facility to receive Medicare reimbursement without the hassle.

The Balanced Budget Act of 1997 will require skilled nursing facilities to bill for all services provided to its Medicare patients.  Effective July 1, 1998 skilled nursing facilities will be required to submit bills directly to Medicare for services which they are most likely not billing for currently.

Under this new agreement, suppliers will bill skilled nursing facilities by individual patient, day of service, and appropriate service code, while the SNF in turn, will bill Medicare.  Suppliers will not be able to submit Medicare Part B claims for SNF patients using the supplier billing number.  Payment will be made to the facility's provider number.  Direct Medicare billing must be done by or on behalf of a nursing home.

The Nursing Homes may still contract with an outside company to submit their bills to the DMERC, but remain responsible for all services provided and must receive payment from Medicare directly.

  • Nursing homes will bill under the facility's provider/supplier number for Part B services including PEN (parenteral/enteral nutrition), wound care, urologicals, ostomies, and tracheostomies.
  • When the resident is covered by Part A, all of the above supplies that may have been provided by an outside supplier and billed to the DMERC (using the outside supplier's number) under Part B, must now be included on the Part A UB-92 claim.
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  • Outside suppliers will no longer be able to submit claims through any provider/supplier number other than that of the facility.

Our Part B Management Billing Program offers:

  • Help obtaining a National Supplier Clearinghouse number
  • All necessity forms involved in Billing
  • On-site training of appropriate people by a nurse for completion of necessary paperwork
  • Reviewing of paperwork to ensure claim is "clean"
  • Electronic billing to all 4 DMERC's (Durable Medical Equipment Regional Carriers), decreasing your payment time
  • All Twenty percent coinsurance billing
  • Claim tracking
  • Problem resolution on Part B claims

Polaris offers Billing Programs for:

  • Parenteral and Enteral Nutrition(P.E.N)
  • Wound Care Supplies
  • Urological Supplies
  • Ostomy Supplies
  • Tracheostomy Supplies