If you feel you can bypass verifying personal injury cases, you are not alone. Just because the majority are not doing something does not mean that it is the best business approach. In our experience working with clinics on their billing and collections, we find a large amount of unpaid personal injury claims in their…
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Coverage Differences As you navigate the waters of Personal Injury claims, it is important to understand the difference between Med Pay and Personal Injury Protection (PIP) when verifying coverage. You will find that PIP covers things that aren’t covered by MedPay. Patients could use their PIP coverage for costs other than medical which could then…
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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…
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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…
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Download Support Tools The KMC University Medicare Verification Form is designed to guide the staff member in collecting the necessary information for Medicare coverage verification. Throughout this course, we advise clinics to refrain from depending on the patient to know their coverage and benefits. It will only lead to bad information and delayed reimbursement. The…
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Verifying QMBs Medicare Qualified Beneficiaries (QMB) hold special status when it comes to cost sharing in your office. It’s important to identify them carefully before any financial transactions have taken place. In 2017 CMS set up a system to help clinics and clearinghouses verify status. The system is called the HIPAA Eligibility Transaction System (HETS)….
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