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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Different Types of Medicare Coverage

To begin your training around Medicare, you must first begin by understanding Medicare coverage. There is a standing opinion that Medicare is so simple there is no need to verify or confirm coverage. Nothing could be further from the truth. Because there are many different types of Medicare, together with various patient types within each...
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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...
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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...
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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...
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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.
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