secondary Archives

Posting Other Types of Payments

In addition to Major Medical payments, we receive remittances from other payers such as Medicare, PI, and Workers’ Compensation. These payment types each require special handling for many different reasons. They must be properly posted and managed to maintain a clean Accounts Receivable (A/R) system. Review this brief tutorial to have a better understanding of…

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Medicare Crosswalk Rules

The Crosswalk Between Medicare & Other Plans The great thing about patients having an insurance plan in addition to Medicare is that very often the claim is forwarded to the secondary carrier automatically once the Medicare carrier completes its claims process. Medicare calls this a “crosswalk feature.” You can assist your patients with this feature…

Medicare Diagnosis Rules

As with all treatments and services in chiropractic, Medicare has its own set of rules, policies, and procedures. It is particularly important to be clear about the diagnosis rules regarding Medicare patients. You should review Medicare’s guidance in your Local Coverage Articles, and revisit them frequently to stay on-top of any changes. Doing so will…

Excluded Service Modifiers Can Make or Break Your Claims

Now that you’ve learned about the difference between modifiers for spinal CMT codes, and those for excluded services, let’s dig a bit more into two critical excluded service modifiers. The GP and GY modifiers may seem unimportant because they are appended to codes that are not covered by Medicare. But misuse or omission of either…

What is QMB?

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.

An Overview of Medicare Verification

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…