Medicare Advantage Plans FAQs Q: What is a Medicare Advantage Plan? A: According to www.Medicare.gov, a Medicare Advantage Plan (like an HMO or PPO) is a Medicare health plan that qualified beneficiaries may choose as part of their Medicare packages. These plans are very similar to traditional Health Management Organizations (HMOs), Preferred Provider Organizations (PPOs)…
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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) is often ignored resulting in serious violations of Medicare regulations.
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It’s important to understand the difference between true verification and an eligibility check. There are so many layers to understanding the coverage a Medicare patient has that you must follow each step methodically. Whether the patient has Medicare Part B or Medicare Part C is the first critical bit of information you must be aware…
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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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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.
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