how to submit medicare claims

Wading through the Medicare claims waters can be tricky at times. Thankfully the process to submit Medicare claims electronically is a rather simple one. We will us Episode Alert’s electronic claims submission.

A quick tip for anyone who is looking for a claims creation software would be to use the free CMS PC-Ace pro32. You can find through MAC. for example here is where you ould go for CGS

Now that we have that out of the way, let’s get down to the business of claims submission. First, you will log in to your episode alert account. If you do not have one you can sign up for the free trial here

Now, navigate to the claims page, and choose the button send claims.

Afterward you will choose the claim file that you want to send to Medicare. We automatically will check to make sure the Physician is PECOS enrolled. Sending a claim with a physician who is not PECOS enrolled automatically gives you a rejection.

It’s that simple. Now you all you need to do is sit back and wait to receive your 999 and 277 files. If you see your 277 and 999 files have been accepted, you will just have to wait for your 835 remit file to see what was paid to you.

If you see that both or either of your 277/999 file has been rejected. You will need to translate the files to see what went wrong.

If you are an Episode Alert Claim alert subscriber we will automatically translate your 277’s and 999’s for you. Giving you the MAC specific error codes that you will need in order to contact your MAC and find out specifically what was the reason for rejection.

If not, you can use PCACE and read pages 2-3 to translate 999. Read pages 4-6 for 277.

We hope this helps you understand how simple and easy it is to send Medicare claims electronically.