Additional “Gap” Coverage Because traditional Medicare Part B coverage is 80% of the allowed charges, beneficiaries may purchase additional insurance to cover the “gap” or other 20%. Some of these payers also pay for services that Medicare never covers. Sometimes, the beneficiary has this coverage through retirement benefits, and other times they must purchase the…
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Participating vs. Non-Participating Provider Status Participation status is a choice that providers make, and is a highly personal decision, but it should be noted that all the regulations associated with Medicare apply regardless of status. In this brief training, we expand on the basics of these participation types and the obligations associated with it. Refer…
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It’s important to recognize the role that the Part B Medicare Administrative Contractor, also known as a MAC, plays in your Medicare relationship. When dealing with Medicare Part B insured patients, the MAC is your “go-to” for many different activities related to providing services. This training outlines the many connections to the MAC that are important for Medicare providers.
Whether a provider of service or a team member working with Medicare billing or verification, you must know how to find your MAC and navigate their website. This short training helps you identify which Medicare jurisdiction your state is in and helps find the way to the tools and resources needed to interact with your MAC. Then, review the next Reference Document that identifies the US jurisdictions set up for Medicare and identifies the current MAC assigned to oversee that jurisdiction. These MACs are contracted for 10-year periods and are subject to change. Then, download and review the last Reference Document that includes all the contact information for each MAC by state. This is a handy tool to save in your Medicare resources for those times you need it.
As you’ve learned by now, your MAC is responsible for many different activities connected to the enrollment of the provider through to processing claims and appeals. This brief training outlines all the activities for which you’ll look to your local MAC to fulfill.
Staying up to date on changes within the Medicare system is an obligation of a compliant office. The Medicare Learning Network is an excellent resource provided by Medicare to keep practices in the know about important billing and other information. This brief tutorial instructs you in how to sign up for the newsletter and to be proactive with staying on top of changes as they come. The associated Reference Document gives you the step-by-step process and links to make it easy! Download this tool and get your office enrolled!