The claim would be filed as any other LTC claim would be, on an 837 I. The request for a demand billing is done after the service provider has issued an Advance Benefit Notice (ABN) to the patient (responsible party) indicating that Medicare will not cover the cost of the service and basically is asking the patient (responsible party) to agree to accept liability for the service. The ABN is prepared by the provider without submitting a claim to Medicare. When the patient (responsible party) request a demand billing it is just a request to submit the claim so that if it is denied the denial can be appealed. The process/name is no different than just submitting a claim for LTC services to Medicare when the provider is absolutely sure the services are covered. So really, "demand billing" is not affected by HIPAA.
Robert C. Pozniak Third Party Liability Operations NYS Department of Health (518) 485-0037 phone (518) 402-0061 fax [EMAIL PROTECTED] ********************************************************************** To be removed from this list, send a message to: [EMAIL PROTECTED] Please note that it may take up to 72 hours to process your request. ====================================================== The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.
