Fee For Service

A Fee For Service (FFS) relationship means the customer has a Medicare Part B supplier number and ProClaim provides Ancillary Billing Services to your facility or organization for a fee per claim billed.

What is the criteria for entering into a Fee For Service relationship?

In order to enter into a Fee For Service (FFS) relationship with ProClaim, your facility or organization must have a Part B supplier number issued by the National Supplier Clearinghouse (NSC). You will be required to comply with 25 Supplier Standards and become accredited to assure that you meet the Quality Standards.

How does a Fee For Service Relationship work?

Upon entering into an agreement with ProClaim, we will begin submitting claims on behalf of your facility or organization using your 10-digit supplier number and/or your organization's NPI #. You receive all revenue and pay for all cost of goods associated with the products and services billed to third party payers, i.e., Medicare, Medicaid, etc. In turn, ProClaim earns a fee per order processed. This fee is a flat rate based upon the total number of orders processed. It is NOT based on the percentage collected or the percentage billed.

How do I obtain a Supplier Number?

You may request an 855S application from the National Supplier Clearinghouse by writing to the NSC at P.O. Box 100142, Columbia, SC 29202-3142 or you may download this .pdf file: CMS 855S Application Form. You must pass a site inspection to prove compliance with the 25 Supplier Standards.

The Supplier must be properly licensed in each state where they provide supplies.