Medicare Archives

Medicare Timely Filing Guidelines

How Much Time Do You Have? We are often asked how much time an office has to file claims to Medicare. This is of particular interest when Medicare is a secondary payer, and the office must wait for the primary carrier to pay or deny before billing. Medicare Timely Filing is addressed in Section 6404…

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Proper Use of the 1500 Claim Form

Guidelines for Using the 1500 Claim Form The 1500 billing form is the connection from the practice to a payer, and in this case the Medicare Administrative Contractor (MAC). Whether you are billing on paper or electronically, each field should be completed exactly according to the guidelines to ensure proper claims payment. These two helpful…

Medicare & Chiropractic- A Unique Relationship

If you struggle with when to bill Medicare and when the patient is responsible for treatment, this mini-class can help you sort it all out. When you are clear on the differences that make Medicare billing unique (e.g., the three covered codes for spinal manipulation, the appropriate use of the ABN form, and the nuances…

Medicare Claims – Paper vs Electronic

What are the Rules? Since October 16, 2003, The Administrative Simplification Compliance Act (ASCA) prohibits payment of initial health care claims not sent electronically, except in limited situations. The exclusion that applies to most doctors of chiropractic is the ‘small provider claims.’ CMS states: The word “provider” is being used generically here to refer to…

The Nuances of Medicare Billing

Medicare plays by its own set of rules. These rules may or may not follow those of other carriers. Medicare’s rules have a nuance all their own (e.g., chiropractors are one of three types of practitioners who can never opt out of Medicare). Medicare also has a specific set of modifiers that help make billing…

Use of the AT Modifier in Chiropractic

Medicare publishes helpful documents and alerts to keep providers in the know about important topics. The use of the AT modifier in Medicare is one of the most critical billing issues providers face. Absence of the AT modifier indicates that the service is maintenance in nature…and therefore, is not payable. Statistics show that overuse of…