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Types of Medicare Coverage

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  • Medicare Curriculum | Section 3
  • Types of Medicare Coverage
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Back to Medicare Curriculum | Section 3

Medicare Basics

How Medicare Works

7 Resources   |   1 Quiz

  • What Is Medicare?
  • Medicare Hierarchy
  • Brief History of Medicare and Chiropractic
  • What is Part B Medicare?
  • Participating vs. Non-Participating Provider Status
  • Medicare Participation and Non-Participation
  • Medicare Basics Reference Documents
  • How Medicare Works

Types of Medicare Coverage

6 Resources   |   1 Quiz

  • Different Types of Medicare Coverage
  • What is Medicare Advantage?
  • Medicare Part C- The Advantage Plans
  • Replacement Plans in Medicare
  • Alternative Medicare Plans-Railroad and United Mine Workers
  • Secondary and Supplemental Medicare Coverage
  • Types of Medicare Coverage

Working with Your Medicare Administrative Contractor (MAC)

6 Resources   |   1 Quiz

  • Your Medicare Administrative Contractor’s Job
  • Your Medicare Administrative Contractor (MAC)
  • Interacting With Your MAC
  • Medicare Learning Network
  • Medicare Coverage Documents
  • Medicare Quick Web References
  • Working with MAC

Mandatory Medicare Enrollment

10 Resources   |   1 Quiz

  • Mandatory Medicare Enrollment for Chiropractors
  • Opting Out is Not an Option
  • FAQ-Medicare Provider Opt-Out
  • FAQ-Medicare Enrollment
  • Par VS Non-Par Comparison
  • EDI Enrollment vs Paper Claims
  • I Submitted My Enrollment-Now What?
  • Help! I’ve Fallen Out of Medicare
  • Maintain Active Enrollment
  • Medicare Enrollment Tips and Tools
  • Mandatory Medicare Enrollment

Medicare in Your Chiropractic Office

4 Resources   |   1 Quiz

  • How Medicare Works with Chiropractic
  • Medicare and Limitations of Chiropractic Coverage
  • How Medicare is Different with Chiropractic
  • Chiropractic Specific Medicare Guidance from CMS
  • Medicare in Your Chiropractic Office

The Qualified Medicare Beneficiary

6 Resources   |   1 Quiz

  • What is a QMB?
  • QMB Compliance
  • How to Verify QMB Status
  • Billing QMB Patients
  • FAQ-Billing QMBs
  • Qualified Medicare Beneficiaries (QMB) Reference Documents
  • Qualified Medicare Beneficiaries (QMB)

Medicare Basics Final Course Assessment

0 Resource   |   1 Quiz

  • Medicare Basics Final Course Assessment

Medicare Advance Beneficiary Notice (ABN)

An Overview of the Advance Beneficiary Notice (ABN)

8 Resources   |   1 Quiz

  • The ABN-Mandatory vs. Voluntary
  • What is the ABN of Non-Coverage?
  • The Role of the ABN Notifier
  • Medicare Chiropractic Services- Covered vs. Non-Covered
  • Medicare Coverage Limitations
  • FAQ-Medicare ABN
  • Advance Beneficiary Notice (ABN) Facts
  • Medicare Advance Written Notice Resources
  • The Advance Beneficiary Notice (ABN)

The Mandatory Advance Beneficiary Notice (ABN) Form

7 Resources   |   1 Quiz

  • Issuing a Mandatory ABN
  • Mandatory ABN Common Errors
  • The ABN Process
  • A Guide to Medicare Modifiers
  • Medicare ABN Templates
  • FAQ-What You Need to Know About QMBs & ABNs
  • Advance Beneficiary Notice (ABN) Reference Documents
  • Mandatory ABN for Spinal Adjustments

Voluntary ABN for Excluded Services

6 Resources   |   1 Quiz

  • The Voluntary Advance Notice ABN Form
  • Is it Mandatory or Voluntary?
  • Statutorily Excluded Services
  • Voluntary ABN Resources & Templates
  • Medicare Modifiers & ABN Implementation
  • Advance Beneficiary Notice (ABN) Reference Documents
  • Voluntary ABN for Excluded Services

ABN Final Course Assessment

0 Resource   |   1 Quiz

  • ABN Final Course Assessment

Medical Necessity & Documentation in Medicare

Start with PART

8 Resources   |   1 Quiz

  • A Brief Overview of PART
  • PART Documentation for Medicare
  • Don’t Forget to do Your PART for Medicare
  • Primary vs. Compensatory Subluxations
  • Documenting PART
  • Documenting PART in an Initial Visit Note
  • Using PART as Part of your ROV Documentation
  • Medicare Benefit Policy Manual – Section 240, Chapter 15
  • Start with PART

Proving Medical Necessity

10 Resources   |   1 Quiz

  • Medicare’s Definition of Medical Necessity
  • What is Medical Necessity?
  • Medicare’s Definition of Medical Necessity
  • Medical Necessity vs. Clinical Appropriateness
  • Active vs. Maintenance in Medicare
  • Medicare Decision Making Matrix
  • Proper Patient Case Management
  • The Relationship Between Box 14 and Medical Necessity
  • FAQ-Medicare Active vs. Maintenance Care
  • Medicare’s Medical Necessity Reference Documents
  • Proving Medical Necessity

Medicare Documentation Requirements

8 Resources   |   1 Quiz

  • Medicare’s Documentation Requirements for Medical Necessity
  • Medicare Documentation Requirements Explained
  • Medicare’s Definition of Medical Necessity
  • Medicare Diagnosis Rules
  • Incident, Burst, or Episode
  • Use of OATS to Create Effective Short Term Goals
  • Be the GOAT of the OATs
  • Medicare’s Documentation Reference Documents
  • Medicare Documentation Requirements

If it Isn’t Signed, It Didn’t Happen

6 Resources   |   1 Quiz

  • Understanding Signature and Authentication Requirements
  • Signature Requirement Errors
  • FAQ-Medicare Signature Guidelines
  • Signature Self-Audit Tool
  • Signature Verification Form
  • Medicare Reference Documents-Signature Guidelines
  • If it Isn’t Signed, it Didn’t Happen!

Medical Necessity & Documentation in Medicare Final Course Assessment

0 Resource   |   1 Quiz

  • Medical Necessity & Documentation in Medicare Final Course Assessment

Verifying the Type of Medicare Plan

Medicare Verification of Benefits

3 Resources   |   1 Quiz

  • An Overview of Medicare Verification
  • FAQ-Medicare Verification
  • Verification of Benefits Resource Documents
  • Medicare Verification of Benefits

How to Avoid Medicare Part C Pitfalls

3 Resources   |   1 Quiz

  • Part C Pitfalls
  • Medicare Advantage Part C Compliance
  • Part C Pitfalls Reference Documents
  • How to Avoid Medicare Part C Pitfalls

Verifying the Type of Medicare Plan Final Course Assessment

0 Resource   |   1 Quiz

  • Verifying the Type of Medicare Plan

Medicare Coding & Billing

Medicare Charge & Fee Rules

7 Resources   |   1 Quiz

  • Participation Status Determines Medicare Fee Schedule
  • Medicare Charge and Fee Rules
  • Review of Medicare Fee Schedule for Participating Providers
  • Review of Medicare Fee Schedule for Non-Participating Providers
  • Fee Schedule Comparison for Medicare Par vs. Non-Par Providers
  • Additional rules and options for statutorily non-covered services
  • Excluded Services
  • Medicare Charge & Fee Rules

Medicare Modifier Mastery

4 Resources   |   1 Quiz

  • Medicare Modifiers to Bill for CMT
  • Commonly Used Modifiers for Chiropractic Medicare Coding
  • Medicare Modifiers for Excluded Services
  • Important Modifier Factoids
  • Medicare Modifier Mastery

Charging for Medicare Maintenance

3 Resources   |   1 Quiz

  • How to Charge for Non-Medically Necessary- Wellness/Supportive or Maintenance Care
  • Collecting for Non-Covered Maintenance Care
  • Three Payment Options for Medicare Maintenance Care
  • Charging for Medicare Maintenance

Medicare Coding & Billing Final Course Assessment

0 Resource   |   1 Quiz

  • Medicare Coding & Billing

The Chiropractic Reimbursement and Compliance Experts

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