Cash-Based Practice and Medicare

Seeing Medicare Patients as a Cash-Based Practice The essence of a cash-based practice is collecting most, if not all, payments across the front counter vs. waiting for payment from a third-party payer. Many providers find themselves on the wrong side of the rules by creating various permutations of this concept, sometimes without even knowing they...
OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.

FDR Guidance

First Tier, Downstream and Related Entities (FDR) Guide Aetna’s in-depth guide to the FDR Medicare Compliance Program is an excellent resource for new employees and for seasoned employees who must deal with an unusual or new situation with one of your Medicare patients. It addresses the attestation requirements for the program in detail and explains...
Oops, your level of membership doesn’t include access to these advanced materials. They are reserved for members working 1-on-1 with our specialists for analysis and training. Please reach out to the HelpDesk to learn more about accessing these materials. Click here to learn more.

Billing Medicare Advantage

Important Facts about MA Plans Although a Medicare Advantage (MA) plan is technically a form of Medicare coverage, it is best to view these plans similarly to your contracted commercial payers. Advantage Plans often follow the same billing rules as regular commercial carriers. If you are a contracted provider for the plan the patient belongs...
Oops, your level of membership doesn’t include access to these advanced materials. They are reserved for members working 1-on-1 with our specialists for analysis and training. Please reach out to the HelpDesk to learn more about accessing these materials. Click here to learn more.

Different Types of Medicare Coverage

To begin your training around Medicare, 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. Because there are many different types of Medicare, together with various patient types within each...
Oops, your level of membership doesn’t include access to these advanced materials. They are reserved for members working 1-on-1 with our specialists for analysis and training. Please reach out to the HelpDesk to learn more about accessing these materials. Click here to learn more.