May 28, 2014 | Medical billing basics
Look to the AMA and website resources for updates. The HIPAA Privacy, Security and Breach Notification rules continue to be revised, and technological change continues to impact the application of those rules. Physician practices must ensure they stay on top of...
May 24, 2014 | Medical billing basics
HIPAA is the acronym for the Health Insurance Portability and Accountability Act. Although HIPAA covers many things, physicians typically are most concerned with HIPAA’s Administrative Simplification provisions, and particularly the Privacy, Security and Breach...
May 16, 2014 | Medical billing basics
If a claim is submitted to Medicare and 3 lines pay and 2 deny–will the two denied lines crossover on that claim? If a provider bills multiple lines to Medicare and Medicare pays one or more lines but denies the others, the paid line(s) (as...
May 9, 2014 | Medical billing basics
How does the Medicare Crossover process affect my Medicaid billing? You will no longer need to submit claims directly to Medicaid for those Medicaid patients who have both Medicare (Parts A &/or B) and Medicaid. Will Medicare Crossover process affect...
Apr 28, 2014 | Medical billing basics
1. What is meant by the crossover payment? When Medicaid providers submit claims to Medicare for Medicare/Medicaid beneficiaries, Medicare will pay the claim, apply a deductible/coinsurance or co-pay amount and then automatically forward the claim to Medicaid....
Apr 10, 2014 | Medical billing basics
See the First and second part for better understanding. Qualifying Individual (QI) A QI is an individual who: ■ is entitled to Part A; ■ has income that is at least 120 percent of the ■ FPL, but less than 135 percent of the FPL; ■ has resources...
