Apr 17, 2013 | Medical billing basics
When checking eligibility, sometimes, there is COMMERCIAL INSURANCE listed on the Medicaid website as primary payer. After checking the primary payer websites, I find that the commercial insurance has terminated – sometimes up to 8 months prior. What can I tell...
Apr 9, 2013 | Medical billing basics
Can you please let me know how to check eligibility on share of cost patients? A Medically Needy recipient is an individual who would qualify for Medicaid, except that the individual’s income or resources exceed Medicaid’s income or resource limits. A Medically...
Apr 3, 2013 | Medical billing basics
Can you clarify if Medicaid only covers Medicare part B premium? Is the patient responsible for the 20% coinsurance? If you are referring to persons who only have coverage as Special Low Income Medicare Beneficiaries (SLMB) or as Qualifying Individuals I (QI1), this...
Mar 29, 2013 | Medical billing basics
What is CPT? CPT was developed by the American Medical Association (AMA) in 1966. The AMA revises and publishes CPT each year to keep pace with changes in medical practice. They delete obsolete procedures, modify existing procedures, and add newly developed...
Mar 22, 2013 | Medical billing basics
Background The MIPPA authorizes a new incentive program for eligible professionals who are successful electronic prescribers (E-Prescribers) as defined by MIPPA. This new incentive program is in addition to the quality reporting incentive program authorized by...
Mar 15, 2013 | Medical billing basics
Medicare Part B covers 10 hours of initial training for a beneficiary who has been diagnosed with diabetes.Diabetes is diabetes mellitus, a condition of abnormal glucose metabolism diagnosed using the following criteria; • a fasting blood sugar greater than or equal...
