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...
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Why Insurance Verification

Why Insurance Verification This quick tutorial explains why insurance verification is an important piece of the financial report of findings (FROF) with the patient. It contains the top tips to make the verification process simple and effective by reviewing the variety of tools available in the KMC University Library. This image provides a sampling of...
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Medicare Replacement Plans

 Download Infographic To expand on your knowledge of Medicare Part C (Advantage) plans, also known as replacement plans, this resource calls out various facts to be aware of as you develop your Medicare education. Remember, these plans replace Part B Medicare, and in some cases, providers are not obligated to join Part C plans in...
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FAQ-What You Need to Know About QMBs & ABNs

QMBs & ABN FAQ’s Q: What is a QMB? Why do I need to know if a Medicare beneficiary is a QMB before billing? A: 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,...
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Medicare Advantage & FDR

First Tier, Downstream, or Related Entity FDR is a Centers for Medicare and Medicaid Services (CMS) acronym for First tier, Downstream, or Related entity. A First Tier Entity is any party that enters into a written arrangement (acceptable to CMS) with a Medicare Advantage (MA) organization to provide administrative or health care services to a...
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FAQ-Medicare Verification

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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