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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Types of QMBs The Medicare Savings Programs (MSPs) was developed to assist low-income Medicare beneficiaries. Individuals who qualify for this assistance are often referred to as Dual Eligibles. All dual-eligible beneficiaries qualify for full Medicare benefits, but the extent or level of benefits for which they are eligible under Medicaid can vary. This is often…
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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…
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