Medicare Archives

Medicare Modifiers Make All the Difference

Medicare modifiers are possibly the most important component in accurate Medicare billing. Understanding and using the right modifier for each situation will reduce delays in payments and lower the number of denied claims. Modifiers provide context for the story of the patient’s experience in the office and clarify important payment considerations necessary for processing. These…

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Commonly Used Modifiers for Chiropractic Medicare Coding

KMC University’s Guide to Medicare Modifiers Reimbursement of a claim by Medicare (and subsequently by secondary payers based on Medicare’s decision) is determined by proper modifier usage. Spinal CMT Codes 98940, 98941, and 98942 must have the proper modifier attached to them to provide Medicare with a clear explanation on whether or not it is…

Medicare Secondary Payer Reference Documents

Download Reference Documents Medicare publishes helpful documents and alerts to keep providers in the know about important topics. Included here are several documents that relate specifically to the rules of billing and compliance when Medicare is the secondary payer. These tools relate to the elements of how to bill Medicare when they are secondary, your…

Medicare Secondary Payment (MSP) Calculation for Accidents

Medicare is Usually Secondary to Accident Coverage Medicare is always the secondary payer for your Medicare beneficiaries if they are involved in accidents. This could mean auto accidents or any other kind of accident where liability is assigned to another party or on-the-job injuries if the Medicare beneficiaries are still working. Depending on the circumstances,…

Medicare Secondary Payment/Group Health Plan Worksheet

Utilizing Medicare Payment Tools This form is one of the most helpful tools in the KMC University Library. When Medicare is a secondary payer, it can be confusing to know what fee schedule to use, how much coinsurance to charge, or whether other insurance may pay for items excluded by Medicare. As you’ll see in…

When Medicare is the Secondary Payer

Although Medicare is usually the primary payer for most beneficiaries, there are times when Medicare takes the second position. Because the federal funds used to pay Medicare claims are so closely monitored, the Coordination of Benefits (COB) department of a Medicare Administrative Contractor (MAC) carefully screens claims to be sure Medicare is paying as they…