Defining QMB The QMB (Qualified Medicare Beneficiary) program is a State Medicaid benefit that supports low-income Medicare beneficiaries through Medicare Part A and Part B premium and cost-sharing discounts and waivers . This includes deductibles, coinsurance, and copays. You will likely have QMB patients seeking treatment in your clinic given the fact that in 2017,…
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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) are often ignored resulting in serious violations of Medicare regulations. NOTE: This tutorial mentions the HIPAA Eligibility Transaction System (HETS) as the source for locating QMB…
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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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Download Reference Documents This page contains helpful tools that provide a deeper dive into the topic of Qualified Medicare Beneficiaries. Here we list timely tools to review, download, and save in your Medicare training documents Cost-Sharing for Medicare Advantage Plans List and Definition of Dual Eligibles Dually Eligible Beneficiaries Under Medicare and Medicaid Prohibition Billing…
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