Medicare Archives

What is the ABN of Non-Coverage?

The Financial Liability Protection The Advance Beneficiary Notice of Noncoverage (ABN) originated from the Financial Liability Protection provisions of the Social Security Act. The Act protects beneficiaries and doctors from unexpected liability for charges associated with claims that Medicare does not pay. The Financial Liability Provisions include: Limitation on Liability Compliance Mandatory Use of the…

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The ABN-Mandatory vs. Voluntary

The Advance Beneficiary Notice (ABN) can be one of the most confusing and frustrating elements of the Medicare process. There is significant confusion about the what, why, and how of proper ABN usage. Conflicting information and pervasive misinformation have been widespread throughout the profession for years. This short training is the first step in putting…

Medicare Administrative Contractors (MAC) Resource

Reference Documents CMS has worked closely with Medicare Administrative Contractors to disperse helpful resources for providers. On this site page is a very useful reference to the current list of Medicare Administrative Contractors (MAC) for Part B Medicare. Every provider should start with their MAC. Download and review this document for all the contact information…

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FAQs-Avoid Medicare Billing Pitfalls

Medicare Billing Mistakes FAQs Q: I heard Medicare allows more visits for longer treatment periods when you use special secondary diagnosis codes. Is this true? A: Medicare has protocols in place that are often based on the severity of the patient’s condition. Although a patient’s condition is reported through diagnosis codes, understanding Medicare’s process for…

Medicare Crosswalk Rules

The Crosswalk Between Medicare & Other Plans The great thing about patients having an insurance plan in addition to Medicare is that very often the claim is forwarded to the secondary carrier automatically once the Medicare carrier completes its claims process. Medicare calls this a “crosswalk feature.” You can assist your patients with this feature…

Billing For Family Members

Medicare Rules for Billing Immediate Family Members Medicare is very specific about how immediate family members should or should not be billed. Become familiar with the specifics of these scenarios to ensure you comply. According to the Medicare Benefit Policy Manual, Section 130 specifically states that any expenses resulting from charges made to immediate relatives…