This short training summarizes the purpose of PART and how it fits into the initial and day to day visits within an episode of care. Most providers find that when they incorporate PART into the look and feel of the objective section of the note, for all patients, it provides a template for proving medical…
Qualified Medicare Beneficiaries (QMB) Reference Documents
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…
FAQ-Medicare Provider Opt-Out
Medicare Provider Options FAQ’s Q: Do I have to enroll in Medicare, or can I see Medicare Beneficiaries (patients) on a cash basis? A: Chiropractors are in a group of three types of providers that cannot “opt out” of enrolling with Medicare. According to the Mandatory Claims Submission Rule you are required to bill Medicare for covered…
Medicare Hierarchy
The “Ladder” of Medicare It’s important to understand the hierarchal relationship between the Office of Inspector General (OIG), The Centers for Medicare and Medicaid Services (CMS), the Medicare Administrative Contractor (MAC), and the Doctor of Chiropractic (DC). OIG: Since it was established in 1976, the Office of Inspector General of the U.S. Department of Health…
Different Types of Medicare Coverage
Different Types of Medicare Coverage Don’t be fooled into thinking that just because Medicare is a national program, it’s all the same for every patient. Seamless and simple Medicare reimbursement starts with understanding the options and plans you’re working with. In this brief training, we expand on the basics of these Medicare types.
FAQ-Billing QMBs
Qualified Medicare Beneficiary Billing FAQ’s Q: Can a provider pass on costs related to excluded (non-covered) services to QMBs? A: Yes, in most cases. QMB rules only apply to Medicare COVERED services, so the billing protections do not apply to excluded Medicare covered services. However, if the patient is a QMB Plus (has full Medicaid coverage), coverage may…