Medicare Coverage Options Here we reiterate what was covered in the previous module. To expand your training around Medicare Advantage plans, you must first begin by understanding Medicare coverage. There is a standing opinion that Medicare is so simple there is no need to verify or confirm coverage. Nothing could be further from the truth….
Download Reference Documents Medicare publishes helpful documents and alerts to keep providers in the know about important topics. On this page, we list three important tools to review, download, and save in your Medicare training documents. To properly determine Medicaid liability for Part C (Medicare Advantage) cost sharing for a dual-eligible (QMB) it is necessary…
Medicare Verification FAQs Q: I called to verify Medicare for a patient and was asked for a PTAN number. What is it & why don’t I have one? A: Medicare Providers are issued Provider Transaction Access Numbers (PTANs) for each place they work. The PTAN identifies the person that renders services to Medicare Beneficiaries in…
Defining QMB The QMB (Qualified Medicare Beneficiary) program is a State Medicaid benefit that guides low-income Medicare beneficiaries through Medicare Part A and Part B premiums and cost-sharing. This includes deductibles, coinsurance, and copays. You will likely have QMB patients seeking treatment in your clinic given the fact that in 2017, 7.7 million people (more…
This tutorial discusses an important compliance related topic that impacts all clinics that accept and treat Medicare beneficiaries. Sadly, in most clinics, the requirements surrounding a Qualified Medicare Beneficiary (QMB) is often ignored resulting in serious violations of Medicare regulations.
It’s important to understand the difference between true verification and an eligibility check. There are so many layers to understanding the coverage a Medicare patient has that you must follow each step methodically. Whether the patient has Medicare Part B or Medicare Part C is the first critical bit of information you must be aware…