noridian medicare allowable for q2035 // netek ama tante

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Source: freeblog.hu

Video: Humana Made Medicare Easy

Claims: Multiple CPIDs: 5010 Noridian Medicare A and B Processing Delays

From February 14, 2011 at 12:00 PM to present, Noridian has experienced 5010 claims processing delays associated with: Receipt of claims to their datacenter. Generation of 277CA reports for all Medicare Trading Partners. The reports may take up to 43 hours to generate. The following payers are affected: CPID 1455 Alaska Medicare CPID 1456 Arizona Medicare CPID 5546 Arizona Medicare CPID 5581 Idaho Medicare CPID 3521 Minnesota Medicare CPID 5584 Montana Medicare CPID 7400 Montana Medicare CPID 1523 North Dakota Medicare CPID 2453 North Dakota Medicare CPID 1459 Oregon Medicare CPID 5515 Oregon Medicare CPID 2454 South Dakota Medicare CPID 5589 South Dakota Medicare CPID 1527 Utah Medicare CPID 2458 Utah Medicare CPID 1462 Washington Medicare CPID 5521 Washington and Alaska Medicare CPID 2466 Wyoming Medicare CPID 3583 Wyoming Medicare Please be aware of these processing delays. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

Medical Management Strategies

(1) Noridian Medicare: (DME Billing) Noridian Medicare has been experiencing major issues with processing 5010 claims since January 1st. Their 5010 system is experiencing intermittence outage. Noridan is working to fix the problem. You may experience delay in payment compensations. (2) Medicare Update on 2012Payments: a) Medicare has begun to release EOBs (Explanation of Benefits) for the beginning of January dates of service and releasing the 10 day hold. b) Medicare is still delaying their 5010 implementation until April 1, 2012. During this 90 day non enforcement period (1-1-3-31-12), Medicare will have the systematic capability to perform up or down version conversions of incoming claim formats (either converting these to the 5010 format when necessary for cross over claims (billing secondaries) and/or leaving them in the 4010 EDI format. What has been occurring is these transitions are not always perfect and has created its own set of issues as well. (3) Medicare and Blue Cross Medical Management Strategies has also noticed that with all the changes going on in the industry for Electronic Data Information going to the new version 5010, there have been a number of significant issues that have occurred for Medicare and Blue Cross payers particularly. Medicare has had a number of issues to deal with this January which included revamping fee schedules, processing claims from clearinghouses in the older version since they put a hold on converting to the 5010 until April 1st, applying deductibles, etc. as well as crossover issues. Although they’ve been trying to notice everyone of how these transitions have been dealt with, there are still a number of issues particularly with clearinghouses to Medicare as well as crossover claims. Clearinghouses are reporting acknowledgements of claims going to Medicare and Medicare then stating they never received the batches.
Source: mmsofslo.com

Noridian Medicare Now Covers Renessa(R) Treatment for Incontinenc… ( NEWARK Calif. Feb. 24 /

Related biology technology : 1. QMed, Inc. Reports July Medicare SNP Enrollments 2. Change in Medicare and Medicaid Legislation Creates Market for Antimicrobial Coatings In the U.S. 3. House and Senate Pass Medicare Legislation to Freeze 2008 Reimbursement for Therapeutic Radiopharmaceuticals at 2007 Levels 4. Medicare Coverage Recommended for In-Home Sleep Testing 5. MedicareCRM(TM) to Speak at IIR Medicare Advantage Congress 6. STAAR Surgicals Collamer(R) IOL Designated as a New Technology Intraocular Lens by the Centers for Medicare and Medicaid Services 7. Medicare Approves in Home Sleep Apnea Testing 8. Medtronic Unit to Pay $75 Million to Settle Whistleblower Medicare Fraud Case 9. Medicare Exemplary Provider Accreditation Awarded to Regenesis Biomedical 10. Arcadian Health Plan Addresses Medicare Doctor Payment Cuts 11. Netsmart Technologies Web Seminar Helps Behavioral Health Organizations Understand Electronic Prescribing and the Importance of New Medicare-Related E-Prescribing Legislation
Source: bio-medicine.org

Stop Using 96402 For Lupron Injections In Noridian Patients

Now you will no longer be able to use 96402 for the administration. In place of chemotherapy drug administration codes 96401- 96549, you should select a code from the 96360-96379 code series. New way: It seems like Noridian (MAC) will suggest the use of the injection code 96372 (Therapeutic, prophylactic, or diagnostic injection [specify substance or drug]; subcutaneous or intramuscular) in place of 96402 for GNRH analogues such as Lupron, Zoladex, and Trelstar.Here’s an instance: A patient steps into your office for a Lupron injection. The urologist makes a clinical assessment through his examination (level-two evaluation & management service) that the patient can continue to get further doses of Lupron. This assessment demands a separate charge. Earlier you would have gone for 99212-25 for the clinical assessment, 96402 for the Lupron administration and J9217 for the drug. For a Nordian patient, now you would report 99212-25, 96372, and J9217. For more on this and for other specialty-specific articles to assist your urology coding, stay tuned to a good medical coding resource like Coding Institute.
Source: ezinemark.com

CMS admits RAC got it wrong

The RAC audits have been a big headache for providers. In some cases, the patient’s sleep test was no longer part of the Medicare common working file, which generally gets purged after five years. So it was up to providers to prove that the test was actually done, and that it was paid for by Medicare, which may or may not have been the case.
Source: hmenews.com

HHS Announces New Affordable Care Act Demonstration Project

Although we encourage you to contact us if you have a legal matter requiring attention, any information you communicate to us by e-mail or blog comments will not be assured of confidential treatment until we agree that there is an attorney-client relationship between us. Nor will any communication between us establish such a relationship, unless and until we specifically agree to serve as your attorneys, which we will not be able to do if our representing you would conflict with the interests of any of our other clients. If you communicate with us by e-mail in connection with a matter for which we already represent you, you should be aware that the security of Internet e-mail is uncertain. By sending confidential or sensitive e-mail messages which are not encrypted you accept the risks of such uncertainty and possible lack of confidentiality over the Internet.
Source: kaufmanandcanoles.com

BehaveNet® Opinion: Firing All Patients With Medicare

When I announced on my favorite physician Web board that I had mailed discharge letters to five patients solely because they have Medicare my colleagues hailed me as their “hero.” I don’t feel like a hero. I opted out of Medicare years ago, but Medicare requires physicians who have opted out to write a letter reaffirming that status every two years. Last year I realized it might have been four years, so I dashed off a letter and waited. You can imagine my shock when, on February 10, 2012, I opened a letter from “Darla” (no signature or last name) dated August 4, 2011, but with no postmark on the envelope. Darla writes that my “affidavit does not meet CMS requirements.” (What affidavit?) She goes on in her 6th grade English: “Opt Out Affidavit was unable to be processed. We did not receive the requested information in a timely manner. A request for information was sent June 13, 2011 to apply for a Type 1 NPI number.” (If Darla intends to say Noridian, the Medicare administrator for my area, sent that information to me, I never received it, and I already have some type of NPI number.) Then she writes that I need to use my “Legal Name” when “filling out the information.” (How does one “fill out information?”) I called Noridian provider enrollment to investigate. “April” reminded me that treating these Medicare beneficiaries without opting out subjects me to prosecution. I don’t want to go to jail, although at least there I might have a right to free medical care. I sent discharge letters to 5 patients and asked my office manager to call them to warn them in advance. Now I am completing a Medicare DISenrollment form. In the future I will require all new patients to demonstrate that they do NOT have Medicare.
Source: blogspot.com

TUMT: Transurethral Microwave Thermotherapy (TUMT)

Noridianmedicare.com: “TUMT, an appropriate therapy for symptomatic benign prostatic hypertrophy (BPH), is a method of delivering microwave heating sufficient to destroy prostatic adenoma tissue without significant damage to surrounding tissue. The FDA has, on May 3, 1996, approved a device for delivering this microwave therapy. TUMT is another nonsurgical therapy for BPH, and is appropriate when the following indications are met. Indications: All of the following characteristics must be present. A. Bladder Outlet Obstruction (BOO) and Lower Urinary Tract Symptoms (LUTS) of significant degree to cause an American Urological Association Symptom Score above seven. A score from 0-7 reflects mild symptoms, from 8-19 moderate, and from 20-35 severe. A patient with mild symptoms may be treated with medicine or, appropriately, receive no treatment at all. A patient with moderate symptoms may be treated with medical or surgical procedures. Noridian leaves this decision to the physician and the patient. B. A peak urine flow rate of 15 milliliters per second or less on a voided volume of 125 milliliters or greater. Relative contraindications: A. Prostate cancer B. Neurogenic bladder C. Active urinary tract infection D. Active cystolithiasis E. Gross hematuria F. Urethral stricture G. Bladder neck contracture H. Acute prostatitis I. Cardiac pacemaker When present, active cystolithiasis or active infection should be treated prior to treatment with TUMT. When prostate cancer and urinary obstruction are both present, TUMT may be appropriate therapy for relief of the urinary obstruction. Absolute contraindication: The presence of a metallic hip replacement.”
Source: blogspot.com

7 Medicare Documentation Errors From Recent Chiropractic Audits

Hopefully, some of these “real life” examples will help you think about improving your own billing, coding and documentation – for Medicare and other payers as well.  If you need more “hands on” assistance with these items, consider attending one of my upcoming SEMINARS where we spend the better part of the afternoon going over the specifics of good, defensible documentation.  And, of course, for those of you who just can’t make the trip, despite it’s massive potential to help you maximize reimbursements and minimize your audit risk (yes, I am a little biased)…stay tuned for more articles in the future.  I’m sure Medicare will continue to dig in and take a look at us – and I’ll be here to report the results to you!
Source: strategicdc.com

Medicare Supplemental Health Insurance Resources Online

Posted by:  :  Category: Medicare

Healthcare solution >> more doctors by / // /When looking into health insurance of any kind the rules, regulations and stipulations often make it so that every word on the policy seems foreign and a bit sketchy. The policy is never laid on it terms that one without industry knowledge would completely understand. Words such as co-payment, deductible, family allowance, preventative vs. routine care often times add confusion in really understanding what is being offered. Health Insurance in general is difficult to understand and often leads us to believe we are being manipulated let alone getting into the next generation of health insurance, Medicare. How is one to determine exactly what is being offered and to finally settle upon a policy that best fits the need with Medicare and Medigap supplemental insurance policies?
Source: business-profit-pro.com

Video: Medicare Deductible

Is Medicare Enough Health Insurance? Your Answer

That being the case, why would anyone buy the combination plan when they can get similar coverage for less money through the Medicare Advantage plan? They do so because they want freedom to choose. The Medicare/Medigap/Supplement combination allows users to keep their own doctors and Medicare Advantage plans don’t. And the combo package gives you better coverage if you travel out of state too.
Source: cifblog.org

Plan F High Deductible Option

What you are doing, in essence, is self insuring for the first $2000 of annual medical expenses that would normally be your share for covered services. Original Medicare will still pay its portion first. For example, a $100 doctor visit would require that you pay the $20 yourself. That $20 would reduce the balance of your deductible for the current year.
Source: affordablemedicareplan.com

Medicare Terms and Definitions

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Source: archerweiss.com

“Medicare: Changes in premiums and deductibles for 2010.” March 10, 2010. NYSUT: A Union of Professionals. www.nysut.org

For inpatient hospital care covered under Part A, the 2010 deductible is $1,100 each benefit period. (A benefit period begins the first day you enter the hospital and ends when you have not received hospital care for 60 days in a row.) While there is no daily coinsurance for the first 60 days of your hospital stay, during days 61 to 90, you will pay $275 per day. The daily coinsurance for lifetime reserve days will be $550 in 2010. (If you have Part A, you are afforded 60 lifetime reserve days, which you can use to cover one or more hospital stays throughout your life.) If you receive care in a skilled nursing facility in 2010, there is no coinsurance for days 1-20. The daily coinsurance for days 21-100 is $137.50.
Source: nysut.org

Medicare Deductible for 2012

For each benefit period Medicare pays all covered costs except the Medicare Part A deductible (2012 = $1,156) during the first 60 days and coinsurance amounts for hospital stays that last beyond 60 days and no more than 150 days. For each benefit period you pay: A total of $1,156 for a hospital stay of 1-60 days, $289 per day for days 61-90 of a hospital stay.
Source: sixtytwoandcounting.com

Looking for Insurance Articles

The reality is that few people experience the worst case scenario. Very few will actually hit the $2,070 deductible for the year. Some estimates show that only 5% of people accumulate over $2,000 of utilization. There are a number of sources that estimate how much the average senior actually accrues in part A and B co-insurance and deductibles for the year but the average seems to show it is about $900 a year. Given this estimate, the average senior would save about $1,207.00 a year on plan F high deductible. If they have a very healthy year, they will save even more. If they have a catastrophically bad year, they will only save $107 but there is no risk involved. At the end of the day, they will save money period.
Source: lookingforinsurance.net

Medicare Part B Premium Deduction for Self Employed

IRS officials said the change came too late to be printed in the Publication 535, Business Expenses, which still states that Medicare Part B premiums are not considered medical insurance premiums for purpose of the self-employed health insurance deduction.
Source: iquote.com

Tricare Help – How can I get information on Medicare Part C?

Posted by:  :  Category: Medicare

HELP ME HELP MYSELF! by eyewashdesign: A. GoldenIn addition, prescription drug costs through TFL are less costly than under Medicare Part D. In fact, the Defense Department advises that the only people who may benefit from Part D coverage are those whose incomes are so low that they qualify for financial aid to pay their Medicare Part B premiums. Moreover, enrollment in Part D will preclude your use of the Tricare Mail Order Pharmacy program, under which you can get a 90-day supply of drugs for the same price that you would pay for a 30-day supply from a local retail pharmacy.
Source: militarytimes.com

Video: Top 10 Medicare Insurance Tips

Medicare Portability Act to help Retiring FilAms and US Government

ABS-CBN News’ Don Tagala reports on U.S. Medicare Philippines, a non-profit organization in Washington, DC that is pushing for the Medicare Portability Act. This act will allow retiring FilAms to enjoy their benefits in the Philippines while at the same time being able to save Medicare at least fifty percent in costs.
Source: bakitwhy.com

Facing Disability? Medicare Benefits Can Help

Orange, CA 4/19/2012 – Most people assume that they will need Medicare benefits at retirement, and do not consider the possibility that they may require it earlier due to disability. If you are in the position of having to consider disability benefits, you may have many concerns regarding your health care coverage. Thankfully, Medicare health care coverage is available to disabled individuals under the age of 65. For example, you may be eligible for Medicare if you have received disability benefits from Social Security or certain disability benefits from the RRB for at least 24 months.
Source: joppel.com

New Medicare Law, Help or Hindrance to US Physicians

That sounds pretty simple, but it doesn’t seem to consider patients with chronic illnesses or patients who don’t follow their doctors’ instructions. Some worry that doctors who want to receive the financial incentives may short shrift their patients or refuse to treat those with chronic or serious illnesses like asthma or Crohn’s disease. Any time the phrases “health care” and “manage costs” appear together in the same sentence, patients start to feel afraid. They naturally assume that in order to “manage costs,” their physicians will spend less time with patients, which could in turn lead to the doctors’ missing things that might have been caught during longer examinations or consultations.
Source: citrusnsg.com

Among Dual Eligibles, Identifying The Highest Cost Individuals Could Help In Crafting More Targeted And Effective Responses

This Health Affairs article by researchers at the Urban Institute analyzes linked Medicare and Medicaid data to examine dual eligibles’ utilization and spending in both programs in 2007. It finds that while the population of people dually eligible for Medicare and Medicaid is indeed costly, it is not monolithic. For instance, although 20 percent of dual eligibles accounted for more than 60 percent of combined Medicaid and Medicare spending, nearly 40 percent of dual eligibles had lower average per capita spending than non-dual-eligible Medicare beneficiaries. Fewer than one percent of dual eligibles were in high-cost categories for both Medicare and Medicaid.
Source: kff.org

Elder Depression – Preventative Assistance

Medicare now covers the cost of annual depression screening in primary-care settings with no cost sharing for beneficiaries. Medicare also covers 60 percent of the treatment for mental health problems, including depression. (Under a 2008 law, that figure is scheduled to rise to 80 percent in 2014.) If you or an elderly loved one may be suffering from depression, taking advantage of Medicare’s annual screening benefit may be a good idea and can greatly improve quality of life.
Source: etrusteecounselor.com

YOUR VIEW: Medicare survey to help improve services

CMS and insurance providers want to make sure Medicare beneficiaries are receiving the highest-quality medical care when they need it, from doctors they trust. The CAHPS survey is one of the tools used to achieve this goal. The survey responses help the government and Medicare plans identify ways to better serve beneficiaries and improve the quality of their health care experience.
Source: al.com

Most Medicare Provides Free Quotes to Internet Users

A lot of people usually think that health insurances are not beneficial. According to reports, there are people who do not want to avail any health insurances. They said that these insurances cannot be obtained unless a person gets sick or they experienced an accident. According to various experts, people are stocked on the mentality that health insurances will not be beneficial to them unless they are on a critical health condition or they have to pay for hospital bills.
Source: freeprnow.com

Seniors Stop Taking Heart Drugs In Medicare ‘Donut Hole’

“We looked at health outcomes within the coverage gap, which averaged about three and half months during a year. While we didn’t find short-term adverse cardiovascular events during that time, it’s really unclear what this discontinuation would do in the long-term. And, we don’t know if they restart the drugs at the beginning of the year when their coverage resets, or if they remain off them,” said study author Jennifer Polinski, an instructor in medicine at Harvard Medical School and an instructor of epidemiology at Harvard School of Public Health in Boston.
Source: ivillage.com

Medicare supplement insurance the help in need to get better benfits

Moreover, it is also a very crucial matter to make the choice of the Medicare supplement plans very carefully. In fact the point is that while choosing your Medicare supplement plans the most important thing that is needed is to compare Medicare supplement plans so that you can easily make the choice of the perfect plans matching your needs. In fact there are also several other options available for choosing Medicare supplement plans. In fact one of the most common means is to go online and look for the Medicare supplement services selling websites where you can easily get the best choice of the Medicare supplement plans comparing one with the other. However, it is always a better idea to go through the offer documents carefully and if you are able to go through the offer documents of all of them, it would be much better to get the best choice of the Medigap plans.
Source: zigyasu.com

Medicare Prescription Drug Assistance can Save $4,000

 Mr. Jones is able to live within his $1300 Social Security check, but the cost of of his prescription medications take a big bite out of his income.  I was able to make his family aware that  their father, who  is covered by Medicare and has limited income and resources, may be eligible for Extra Help — available through Social Security — to pay part of his monthly premiums, annual deductibles, and prescription co-payments.
Source: marshagoodmanattorney.com

Improve Aging in Connecticut

The Courant welcomes letters on matters of public interest. Please fill out the form below. Your full name, hometown, phone number and e-mail address are required for verification, but only your name and hometown will be used. Your letter should be exclusive to The Courant. Letters should not exceed 200 words. We reserve the right to edit and shorten the text. Anonymous letters, letters using a pseudonym and open letters will not be published. Writers will ordinarily be limited to one letter published in the print version every two months. Your submission will be reviewed and, if accepted, will be edited and posted to the Opinion Page. If your item is breaking news or is not intended for publication, please send your item using the News Tips form by clicking here.
Source: ctsenaterepublicans.com

NY: Medicare picks region as a test site

Posted by:  :  Category: Medicare

Record shop Ithaca, NY by exaktaMaking digital products easier to use takes more time than normal in discerning and studying user behaviors, capturing those learnings and then using them to design better and more intuitive devices and interfaces. However, muc…
Source: taxbusinessadvisor.com

Video: New York: Medicare Fraud Summit Consumer Panel

Medicare Saves Money from the NY Times : Health Care for All Philadelphia

O.K., the obvious question: If Medicare is so much better than private insurance, why didn’t the Affordable Care Act simply extend Medicare to cover everyone? The answer, of course, was interest-group politics: realistically, given the insurance industry’s power, Medicare for all wasn’t going to pass, so advocates of universal coverage, myself included, were willing to settle for half a loaf. But the fact that it seemed politically necessary to accept a second-best solution for younger Americans is no reason to start dismantling the superior system we already have for those 65 and over.
Source: phillyhealth.org

Bellavia on Medicare and NY

The race for the newly drawn 27th congressional district could be one of the most interesting contests this year. Freshman Democrat Kathy Hochul is hoping to win re-election there, and two Republicans have already lined up to challenge. But David Bellavia has picked up several endorsements ahead of the June 26 primary, and he is confident he can beat former Erie County Executive Chris Collins and Hochul.
Source: capitaltonight.com

Competition can save Medicare money

I have been saying for the longest time that one of the reasons for skyrocketing health care costs is the lack of competition and bidding for health care products and services.  There is essentially an oligopoly in health care today wherein a few major corporations with strong political ties and lobbies are able to assure their standing as providers of health care.  It is absolutely outrageous that the cost of health care is rising multiples above general inflation. 
Source: medrants.com

CMS Reveals First 27 ACOs in Medicare Shared Savings Program

The ACOs span 18 states and will cover roughly 375,000 beneficiaries. Five of the 27 ACOs are participating in the Advance Payment ACO Model, under which each ACO will receive advance payments to help cover the costs of establishing an ACO infrastructure. The names of the Advance Payment ACOs were not disclosed in the news release. CMS is now reviewing more than 150 applications from ACOs seeking to participate in MSSP beginning July 1. Of those applicants, more than 50 are applying for the Advance Payment ACO Model. The first 27 ACOs to participate in the MSSP program are listed here, along with their respective locations: 1. Accountable Care Coalition of Caldwell County, LLC (N.C.) 2. Accountable Care Coalition of Coastal Georgia 3. Accountable Care Coalition of Eastern North Carolina, LLC 4. Accountable Care Coalition of Greater Athens Georgia 5. Accountable Care Coalition of Mount Kisco, LLC (N.Y.) 6. Accountable Care Coalition of the Mississippi Gulf Coast, LLC 7. Accountable Care Coalition of the North Country, LLC (N.Y.) 8. Accountable Care Coalition of Southeast Wisconsin, LLC 9. Accountable Care Coalition of Texas, Inc. 10. AHS ACO, LLC (N.J.) 11. AppleCare Medical ACO, LLC (California) 12. Arizona Connected Care, LLC (Arizona) 13. Chinese Community Accountable Care Organization (N.Y.) 14. CIPA Western New York IPA, doing business as Catholic Medical Partners (N.Y.) 15. Coastal Carolina Quality Care, Inc. (N.C.) 16. Crystal Run Healthcare ACO, LLC (N.Y. and Pa.) 17. Florida Physicians Trust, LLC 18. Hackensack Physician-Hospital Alliance ACO, LLC (N.J.) 19. Jackson Purchase Medical Associates, PSC (Ky.) 20. Jordan Community ACO (Mass.) 21. North Country ACO (N.H.) 22. Optimus Healthcare Partners, LLC (N.J.) 23. Physicians of Cape Cod ACO (Mass.) 24. Premier ACO Physician Network (Calif.) 25. Primary Partners, LLC (Fla.) 26. RGV ACO Health Providers, LLC (Texas) 27. West Florida ACO, LLC
Source: beckersorthopedicandspine.com

Turner, Dems Trade Barbs On Medicare Vote

“When given the chance to protect Medicare, Representative Bob Turner reconfirmed his commitment to ending Medicare making things harder for New York seniors,” said Josh Schwerin of the Democratic Congressional Campaign Committee.  “Representative Bob Turner can try to hide all he wants but his intentions are crystal clear — Turner will protect massive tax breaks for billionaires and Big Oil but will vote to end the Medicare guarantee and increase costs for seniors in New York.”
Source: patch.com

CMS unveils 27 Medicare ACOs

The Centers for Medicare & Medicaid Services today announced its long-awaited list of 27 Accountable Care Organizations (ACO) under the Medicare Shared Savings Program, as well as five Advance Payment ACOs, both beginning April 1. The 27 Medicare ACOs through the Shared Savings Program will serve an estimated 375,000 beneficiaries in 18 states. Coupled with the 32 Pioneer ACOs and six Physician Group Practice Transition Demonstration organizations that both started in January, the total 65 ACOs will serve 1.1 million Medicare beneficiaries, CMS said in a statement.
Source: fiercehealthcare.com

ACOs Multiply As Medicare Announces 27 New Ones

Harold Miller, president and CEO of the Network for Regional Healthcare Improvement and executive director of the Center for Healthcare Quality & Payment Reform in Pittsburgh, says ACOs will continue to be the model of the future, even if the Supreme Court strikes down the health care law. The private sector, he says, has been moving in the direction of coordinated care for years.
Source: kaiserhealthnews.org

Major NY Hospital Caught Bilking Medicare

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Source: marksadaka.com

Tricare Help – How can I get information on Medicare Part C?

Posted by:  :  Category: Medicare

ROBERT L. HUFFSTUTTER'S HEALTHCARE PLAN FOR AMERICA by roberthuffstutterIn addition, prescription drug costs through TFL are less costly than under Medicare Part D. In fact, the Defense Department advises that the only people who may benefit from Part D coverage are those whose incomes are so low that they qualify for financial aid to pay their Medicare Part B premiums. Moreover, enrollment in Part D will preclude your use of the Tricare Mail Order Pharmacy program, under which you can get a 90-day supply of drugs for the same price that you would pay for a 30-day supply from a local retail pharmacy.
Source: militarytimes.com

Video: Guide to Medicare Part A and Part B

Ask The Experts: Retirement

A. The reason no one can answer that question is because one size doesn’t fit all. Whether Medicare Part B is right or wrong for you is something you’ll have to figure out for yourself. You’ll have to compare the benefits Part B offers with your other medical coverage. In short, Part B helps cover medically necessary services such as doctors’ services, various kinds of therapy, outpatient care, durable medical equipment, home health services, including part-time and intermittent nursing care, and other medical services. Part B also covers some preventive services. If you find that these benefits fill gaps in your present coverage or enhance those that you can already receive, and it makes financial sense to pay the premiums, sign up for Part B. If not, don’t.
Source: federaltimes.com

A Few Differences Among Medicare Part A and Part B and Medigap Insurance

Medicare Part A provides for inpatient healthcare facility care, covering up 90 days per benefit period and 60 reserve days for your lifetime, as well as Hhundred days per benefit within a skilled nursing facility for treatment. To qualify for the skilled nursing facility care, however, you must have stayed in the hospital for three successive days within 30 days prior to admission to the power. Hospice care can also be furnished if you are confirmed to be terminally ill by your medical professional. Home health care is covered throughout Medicare Part A for 100 times, with the same stipulation that you have stayed in the healthcare facility for three days, these kinds of being within 14 days prior to receiving treatment and being homebound. Medicare Part B deals with many outpatient doctor companies. These include regular visits to the doctor as well as some precautionary services, durable health-related equipment, ambulance companies for emergency travel, and x-rays and medical tests. It also includes outpatient physical, conversation, and occupational therapy services and also other home health companies.
Source: autoinsurance-northcarolina.org

Does Medicare Cover Preventive Care?

Garrett Ball is the owner of Medicare-Supplement.US, as well as several other Medicare-related web resources. As an independent broker, Garrett assists people going on, or already on, Medicare with comparing the various Medicare plan options in an unbiased way and in a centralized place. Garrett’s position as an independent agent and experience specializing in this field give him the unique ability to help others navigate the Medicare “maze”.
Source: medicare-supplement.us

American Heart Association reports Patients often stop taking heart drugs during Medicare coverage gaps

“Rather than prompting patients to switch to lower-cost alternatives, we found that sudden exposure to 100 percent of drug costs in the Part D coverage gap led to abrupt discontinuation of essential cardiovascular medications,” said Jennifer M. Polinski, Sc.D., M.P.H., study lead author and instructor in medicine at Harvard Medical School in Boston, MS. “Any drug insurance policy that negatively influences essential cardiovascular drug use needs to be changed.”
Source: clarksvilleonline.com

CMS: Medicare Advantage, Part D To Get 3 Percent Boost In 2013 Reimbursements

Bloomberg: Nursing Homes Won’t Have To Hire Independent Pharmacists The U.S. Centers for Medicare and Medicaid Services backtracked on a plan that would have required nursing homes to hire independent pharmacists to assess residents’ prescriptions. Regulators “decided to further study the issue for future policy considerations,” Jonathan Blum, deputy director of the agency, said in a conference call with reporters late yesterday. The centers said in October it was considering stricter rules to oversee patients’ drug regimens, an announcement that sent the stocks of nursing home pharmacies, including Omnicare Inc. (OCR) and PharMerica Corp. (PMC), tumbling (Wayne, 4/3).
Source: kaiserhealthnews.org

Illinois Medicare Supplement Plan G

Posted by:  :  Category: Medicare

Gang of Six - Cartoon by DonkeyHoteyRemember, simply because providers must offer the same plans does not mean they are all reputable or dependable. And when it comes time to collect on your benefits, a low cost will not help you if the insurance company cannot deliver. Stay with the major names and get peace of mind in knowing you’re insured with a stable, reliable provider. Blue Cross Blue Shield of Illinois, for example, has been providing Medicare supplement insurance to folks just like you for years. Because they are dependable, they will continue to offer competitive prices and great benefits for years to come.
Source: ssiinsure.com

Video: Progress Illinois: Democrats Say GOP Budget Will “Gut Medicare”

Marathon Pundit: Illinois: Increasing cigarette tax is the wrong fix on Medicaid costs

Financially-moribund Illinois is looking to slash a whopping $2.7 billion from its Medicare budget. For those of you who are wondering–yes, this is the same Illinois that raised personal income taxes by 67 percent last year. Businesses were clobbered too, but they were not hit as hard–their rate went up ‘only’ 46 percent. Yet the Prairie State is still expected to end the fiscal year with an $8 billion deficit. One proposal from Democratic Governor Pat Quinn to make the Medicaid cuts less steep is to hike the cigarette tax by $1 a pack. As I’ve mentioned countless times in this space, revenue from smoking-related taxes almost never matches politicians’ forecasts. The cash shortfall then has to be made up elsewhere. Besides, Illinois’ tax-and-spend-even-more way of doing things has led to the state having the nation’s lowest credit rating. We don’t need more of the same.
Source: blogspot.com

IL Dept of Insurance Recognized for Exemplary Performance of its Senior Health Insurance Program

SPRINGFIELD–(ENEWSPF)–April 17, 2012.  The Illinois Department of Insurance (DOI) has received recognition from the U. S. Centers for Medicare and Medicaid Services (CMS) that Illinois excels in several areas related to exemplary performance for its Senior Health Insurance Program.  The Senior Health Insurance Program (SHIP) is a free statewide health insurance counseling service for Medicare beneficiaries and their caregivers.  SHIP is sponsored by the Illinois Department of Insurance.  CMS notified DOI earlier this month and commended the department for the high ranking received on its National Performance Reporting (NPR) stats. 
Source: enewspf.com

Illinois Winner Romney Supports Ryan Ideas On Medicare, Medicaid

ABC: Fact Check: RNC Ad Hits Obama For ‘Higher Costs’ On Health Care The Republican National Committee is hammering President Obama in a new TV ad over what it calls a “broken promise”  to bring down health care costs for families. The ad … airs this week in the pivotal swing states of Nevada, New Mexico, Ohio, Virginia, Pennsylvania and Florida, the RNC said. The ad seems aimed at exploiting what a Kaiser Family Health Foundation poll revealed this month as the most widely cited negative perception of Obama’s health care law: increased costs overall (Dwyer, 3/20).
Source: kaiserhealthnews.org

Affordable Care Act Helps 201,818 on Medicare in Illinois Save $139,094,886.04 on Prescription Drugs

Washington, DC–(ENEWSPF)–March 19, 2012. As the second anniversary of the Affordable Care Act approaches, new data shows that 201,818 Medicare beneficiaries in Illinois saved a total of $139,094,886.04 on prescription drugs because of the new health care law, Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services (HHS), announced today, an average of $689.20 per individual.  Savings for seniors include a one-time $250 rebate check to seniors who hit the “donut hole” coverage gap in 2010 and a 50 percent discount on covered brand-name drugs in the donut hole in 2011.
Source: enewspf.com

Democratic Party of DuPage County, Illinois: We still need “Medicare for all”: John Nichols in The Nation

Could a Supreme Court decision lead the way to universal, single-payer coverage? Read John Nichols, writer for The Nation, on this week’s debates here: http://www.thenation.com/blog/167072/supreme-court-wrangling-aside-we-still-need-medicare-all?utm_source=PI+Extra+3.27.12&utm_campaign=PI+email+3.27.12&utm_medium=email
Source: blogspot.com

Democratic Candidates Say Ryan Budget Will 'Gut Medicare' (VIDEO)

Duckworth, an Iraq War veteran who will face Tea Party lightning rod Joe Walsh (R-8) come November, said most notably Ryan’s plan will “gut Medicare as we know it.” According to the New York Times, Ryan’s budget plan would slash Medicare funding by $205 billion and would turn the government program into a free-market voucher system. Additionally, the Republican budget would reduce the number of tax brackets, which max out at 35 percent, from six to two at 10 percent and 25 percent rates. By 2016, the Ryan plan would reduce the country’s $1.18 trillion deficit to $241 billion compared to the $529 billion deficit proposed by Obama’s budget, which includes large military cuts rather than slashing entitlement programs. The Democratic candidates blasted Ryan’s budget saying it would benefit the country’s richest citizens while cutting essential government services to America’s neediest populations: the poor and elderly. “Everybody understands that we’re going to have to make decisions on where to reduce spending, but to do it on the backs of the people who can afford it the least, to do it in a way that’s going to end Medicare and turn it into something we don’t recognize … is absolutely wrong,” said Brad Schneider, who is challenging incumbent Bob Dold (R-10).
Source: progressillinois.com

Tricare Help – How can I get information on Medicare Part C?

Posted by:  :  Category: Medicare

GIMME SOME OF THAT GOOD 'OLE OBAMA DOUBLESPEAK by SS&SSIn addition, prescription drug costs through TFL are less costly than under Medicare Part D. In fact, the Defense Department advises that the only people who may benefit from Part D coverage are those whose incomes are so low that they qualify for financial aid to pay their Medicare Part B premiums. Moreover, enrollment in Part D will preclude your use of the Tricare Mail Order Pharmacy program, under which you can get a 90-day supply of drugs for the same price that you would pay for a 30-day supply from a local retail pharmacy.
Source: militarytimes.com

Video: Detroit: Medicare Fraud Summit Preventing Health Care Fraud Panel

Social Security, Medicare report card on tap

Critical to reining in the United States’ long-term debt will be finding ways to control the burgeoning costs of Medicare and Social Security, both of which will face serious funding shortfalls over the next two decades.
Source: mauricefrazier.com

Health Costs Up Nearly 6%; Medicare Trustees Solvency Report Due Monday

CNN Money: Social Security, Medicare Report Card On Tap Critical to reining in the United States’ long-term debt will be finding ways to control the burgeoning costs of Medicare and Social Security, both of which will face serious funding shortfalls over the next two decades. On Monday, the trustees of those programs will offer their annual update on just when those shortfalls will occur. Experts said they expect the trustees’ conclusions to be similar to their findings last year. Then again, “It’s like trying to predict elections. You never know,” said Don Fuerst, senior pension fellow at the American Academy of Actuaries (Sahadi, 4/20).
Source: kaiserhealthnews.org

MEDICARE CARD REPLACEMENT + Article & Pictures

And that means you might want in order to achieve forms filled out for medical health insurance benefits, 401k deductions, the list continues. If that’s the case, Social Security will replace it free of charge, nevertheless that you’re only for three replacement cards in per year and 10 throughout your daily life. For income verification, they’ll not accept prior year tax information or bank statements showing direct deposit of income, medicare card replacement.     Note: All documents should be either originals or copies certified with a issuing agency. Listed here is really a summary of documents necessary to ensure assets and income. Section one of each list comes with documents necessary to prove citizenship and identity. To be able to obtain yet another one card you have got to complete an Application more than a Social Security Card Form SS-5 and also have documents that prove that you’re a U. The Medicare Card Replacement Site is definitely a quick, secure solution to really manage to get their replacement Medicare card.     Replacement of each card can also be easily done online. Which you might make use of this amazing site to obtain an unfamiliar card if a Medicare card is red, white and blue, and when this really can be your proof which you’ve got Medicare medical health insurance. Using both of these forms the exact same question always arises. You’ll also need documents proving for which you own U. Also, you might not be plagued by these limits when you are able prove you first need the card to avoid a substantial hardship.     Click the Government tab, simply click State Agencies, simply click Health Care Policy and Financing, and simply click Medicaid. As an example, as proof of identity, Social Security must see youre: U. The exact application gives you for multiple benefits programs allowing it to be extremely confusing. In either during these cases there is no need to send your employee off to obtain an unfamiliar Social Security card. passport, Certificate of Naturalization or Certificate of Citizenship.     Whether you apply across the Internet or phone, it requires the exact same period in period to have the card. Medicare card replacement try not to make it by your side. When you employ an unfamiliar employee there exists a number of information to assemble meant for that individual into your payroll system. Legal name changes along with other exceptions try not to count toward these limits. In line with the Social Security Administration, there were thirty different versions of a typical SSN card issued since 1936.     All concerning the world connected with medicare card replacement. Unless you make use of this service already registration is going to need. ALL assets and resources should be reported and documented it doesn’t matter how all are titled amongst the applicant and community spouse or any 3rd party and no matter perhaps the asset or resource is exempt. This causes it to difficult to identify when you want to for a valid card. com allows expert authors in a huge selection of niche fields to seek massive degrees of exposure in turn of this submission in their quality original essays. The program should really be completed and filed at the earliest opportunity when an applicant is eligible or is a couple of weeks of being entitled to benefits.     Medicare card replacement otherwise an internet savvy person, after that it is possible to call the social security office inside our area. Your organization may even offer benefits that need further forms be filled out as well. This really is definitely a needed document. The replacement card also receive an identical name and number as your previous card. Your payroll provider must have certain data as being remembered as good at process an unfamiliar hires pay. And assuming you have, maybe you are surprised if you have a employee is discouraged from getting another card, despite the fact first few duplicates come in for free. All information withwithin software program should be verified by independent documentation. When you’ve got a damaged Medicare ID, you will have to remember to displace it as fast as they can be, medicare card replacement.     This really is known as fraud during an applicant to intentionally neglect to report all asset information or to report false information. consular report of birth, U. Medicare card replacement social security cannot accept photocopies or notarized copies of documents. Handwritten lists, self-generated computer printouts, or notes are not thought to be verification. Identity Social Security will accept only certain documents as proof of identity. For instance, if your child comes with a merchant account containing the kids money, even so the parents name is on their account, the kid must imply he / she deposited money from child.     You imagine you ought to continue a copy than me on file. But what looking for when you are doing. Medicare card replacement in order responsible employer may very well nothing just like the thought of failing to have a social security card within check when processing your hires paperwork. A number of each data you will need to assemble is name, address, social security number, rates of pay and direct deposit information. If you’ve got’ve moved but is not reported your brand-new address on to the SSA, that you’ll have to try and do this before requesting your card. A few during these are first name and last name since it seems on your own information, your Social number and then your date of birth.
Source: otots.com

Abingdon Social Security Office to Close For Two Weeks

Most Social Security services do not require a visit to an office. For example, anyone wishing to apply for benefits, sign up for direct deposit, replace a Medicare card, obtain a proof of income letter or inform us of a change of address or telephone number may do so at www.socialsecurity.gov or by dialing the national toll-free number, 1-800-772-1213 (TTY 1-800-325-0778).
Source: daggerpress.com

Walgreens $25 Gift Card With Transferred Prescription Coupon

*Fine Print – not valid in AL, AR, MA, MS, ND, NJ, NY and PR. Expires 5/31/2012. Offer is not valid for any holder who is a beneficiary of a federal healthcare program, such as Medicare Part D, Medicare Advantage, Medicare Part B, Medicaid, TRICARE or the Federal Employees Health Benefits Program.
Source: hotcouponworld.com

What are Medicare Parts A B C D

Posted by:  :  Category: Medicare

319 | Tragedies of Medicine by The DoctrMedicare Part ABCD, it sounds like some kind of alphabet soup. But if we go out of alphabetical order, it will be easier to explain. Medicare Part A, B and D is the total coverage package offered by Medicare. Part A is hospital insurance. Part B is medical insurance. Part D is prescription drug coverage.
Source: freegiveaway.org

Video: Linda Meckler Medicare Parts ABCD.MP4

Cool Medicare Part A B C D images

Scenario Three: A primary care doctor sees a Medicare patient for an office visit. She thinks her patient has heart failure, starts the initial management. She orders labs and a echocardiogram. The echocardiogram is read by the cardiologist who recommends the patient come and see him. The primary care doctor spent around 15 minutes with patient and gets paid around for the office visit. The patient’s pharmacist later calls and says the medication that was prescribed must be changed due to insurance formulary restrictions. The doctor spends a minute or two reviewing that patients chart before deciding on an alternative medication. The doctor does not receive any additional reimbursement for this service. She was still only paid total. Later, the patient drops off some paperwork for the physician to fill out for the medical insurance. The doctor spends around 10 minutes filling out that paperwork and having his nursing staff fax the complete forms to the insurance company. The doctor does not receive any additional reimbursement for this service. She was still only paid total.
Source: coloradomedicaremedigap.com

What is your decison on your Medicare Part A B C D

I am the author of 2 self-published books. Ghost Kids Trilogy and Fight Your Medical Insurance Nightmares!! Let me show you how. I also have many electronic books on www.amazon.com, www.barnesandnoble.com and www.smashwords.com. I am a journalist, teacher, and public speaker. I have been in Toastmasters for years. Linda Meckler www.lindamecklerauthor.com
Source: wordpress.com

What Medicare Does and Does Not Pay in 2010

Supplemental Coverage VS Part C coverage. As previously stated, Part C coverage by a private carrier is administered much like group health with co-pays, deductibles and a selection of their doctors. Supplemental plans vary in coverage and the yearly supplement premium is based on the degree of coverage.Ther are supplemental plans that pay all of the cost medicare does not pay under Part A and B to plans that may have a $2000 yearly deductible. The advantage of the supplemental plans is that you have control over which doctors you go to,anytime and anywhere. Of course the less you have to pay for coverage of the un-paid medicare cost the more your supplemental premiums will cost. Keep in mind that regardless of the cost for supplemental coverage, the premiums are far less than traditional non-medicare major medical coverage, and with better benefits.
Source: trendlearn.com

Medicare Open Enrollment Ends Dec. 7!

BACKGROUND:  SHINE (Serving the Health Information Needs of Elders) provides free health insurance information, counseling and assistance to Massachusetts residents with Medicare and their caregivers. ABCD’s Events for Open Enrollment are continuing throughout Boston and are a chance for seniors and disabled adults on Medicare to learn about changes in Medicare Drug Plans for the 2012 year. After each presentation, FREE on-site Medicare counseling & assistance will be available!
Source: bostonabcd.org

2012 Medicare Premiums, Deductibles and Co

Enrollees in Medicare Part D prescription drug plans pay premiums that vary from plan to plan.  Beginning in 2011, Part D enrollees whose incomes exceed the same thresholds that apply to higher income Part B enrollees must also pay a monthly adjustment amount. The regular plan premium will be paid to their Part D plan, and the income-related adjustment will be paid to Medicare.  The amounts by income level are below.
Source: medicareadvocacy.org

Medicare Health Insurance

Medicare Part C is the “private” portion of Medicare. In Part C, a private insurer has contracted with the government to take over the management of all of your Medicare benefits. You pay premiums directly to this private insurer. Your benefits are then all provided through this private insurer. That is the insurer and pays claims on your behalf. Part C is optional and you still have to pay the Part B premium. The difference is that your benefits are provided by a private insurer and not the government. Both Medicare Advantage and Medicare supplemental insurance covers the gaps left by the original coverage. You do not need both. The difference is that Medicare Advantage pays instead of Medicare, whereas supplements pay AFTER Medicare pays;
Source: infobarrel.com

DHS Seeks Comments on Medicare

Posted by:  :  Category: Medicare

Occupy St Pete march through downtown St Pete, No. 1 by Fifth World ArtClients enrolled in both programs currently receive Medicaid-covered services through Hawaii’s QUEST Expanded Access (QExA) program.  Under the proposed demonstration, those same covered services will be combined with Medicare services, and delivered through the QExA health plans.  The integrated program creates a single, inclusive package of preventive, acute, pharmacy and long-term services that otherwise are covered by Medicare or Medicaid.  
Source: mauitvnews.com

Video: Medicare and Medicaid: What’s it all mean?

An Update on CMS'S Capitated Financial Alignment Demonstration Model For Medicare

Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid.  These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans that seek to integrate benefits and align financial incentives between the two programs.  On January 25, 2012, CMS issued a memorandum providing additional guidance for organizations interested in offering health plans in the capitated financial alignment demonstration.  The guidance details the state demonstration approval and plan selection processes, compares existing Medicare and Medicaid managed care plan requirements, and sets out CMS’s preferred standards for the capitated financial alignment demonstration model.  
Source: kff.org

Getting Acne: Do not Try This at Home

Carefully examine your skin in the mirror and see the bright red pimples, just begging to be squeezed out or pops. While appearing acne can seem like a satisfactory solution, can make your acne problem worse. When you do an experiment to extract the pimples on your own, you can push the contents deeper into your skin, introduce more bacteria in it to the nails clean, and the risk of scarring. Your best bet is to visit a dermatologist or a beautician to sterile hand and using the appropriate tools.
Source: medicare-medicaid.info

Video: Obama Blasts GOP Medicare, Medicaid Plans

QUESTION: Mr. President, you said yesterday that it would unprecedented for a Supreme Court to overturn laws passed by an elected Congress. Yet that is exactly what the court’s done during its entire existence. If the court were to overturn individual mandate, what would you do or propose to do for the 30 million people who wouldn’t have health care after that ruling? PRESIDENT OBAMA: Well, first of all, let me be very specific. We have not seen a court overturn a law that was passed by Congress on a economic issue, like health care, that I think most people would clearly consider commerce — a law like that has not been overturned at least since Lochner, right? So we’re going to back to the ’30s, pre-New Deal. And the point I was making is that the Supreme Court is the final say on our Constitution and our laws, and all of us have to respect it, but it’s precisely because of that extraordinary power that the court has traditionally exercised significant restraint and deference to our duly elected legislature, our Congress. And so the burden is on those who would overturn a law like this. Now as I said, I expect the Supreme Court actually to recognize that and to abide by well-established precedents out there. I have enormous confidence that in looking at this law, not only is it constitutional, but that the court is going to exercise its jurisprudence carefully because of the profound power that our Supreme Court has. As a consequence, we’re not spending a whole lot of time planning for contingencies. What I did emphasize yesterday is there is a human element to this that everybody has to remember. It’s not an — this is not an abstract exercise. I get letters every day from people who are affected by the health care law right now even though it’s not fully implemented, young people who are 24, 25, who say: You know what? I just got diagnosed with a tumor. First of all, I would have not gone to get a checkup if I hadn’t had health insurance. Second of all, I wouldn’t have been able to afford to get it treated had I not been on my parents’ plan. Thank you and thank Congress for getting this done. I get letters from folks who have just lost their job, their COBRA is running out, they’re in the middle of treatment for colon cancer or breast cancer and they’re worried, when their COBRA runs out if they’re still sick, what are they going to do, because they’re not going to be able to get health insurance. And the point I think that was made very ably before the Supreme Court, but I think most health care economists who have looked at this have acknowledged, is there are basically two ways to cover people with pre-existing conditions or assure that people can always get coverage even when they have bad illnesses. One way is a single-payer plan. Everybody is a under a single system, like Medicare. The other way is to set up a system in which you don’t have people who are healthy but don’t bother to get health insurance, and then we all have to pay for them in the emergency room. That doesn’t work, and so as a consequence, we’ve got to make sure that those folks are taking their responsibility seriously, which is what the individual mandate does. So I don’t anticipate the court striking this down. I think they take their responsibilities very seriously. But I think what’s more important is for all of us, Democrats and Republicans, to recognize that in a country like ours, the wealthiest, most powerful country on earth, we shouldn’t have a system in which millions of people are at risk of bankruptcy because they get sick or end up waiting until they do get sick and then go to the emergency room, which involves all of us paying for it. 
Source: kaiserhealthnews.org

Understanding the Difference Between Medicare and Medicaid Meaningful Use

e-MDs offers a host of affordable, certified EHR solutions for physicians and facilities looking to modernize or enhance their services with the latest electronic health records technology. e-MDs is committed to providing affordable and integrated EMR and Practice Management Software solutions, including clinical, financial and document management modules designed to automate medical practice processes and chart management – delivering the clinical tools needed to succeed in today’s health care environment.
Source: ezinemark.com

Improper Medicaid Billing Costs New Yorkers Millions: Audit

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Source: wnyc.org

The Centers for Medicare and Medicaid Services Declines to Provide Coverage for Laparoscopic Sleeve Gastrectomy: Disappointing News for Patients, Surgeons, and Advocates

Let me close my editorial on a happy note. Dr. David Provost, president of the ASMBS Foundation, announces in this month’s “ASMBS Foundation News and Update” that Dr. Kelvin Higa has been selected to receive the 2012 “Outstanding Achievement” award. What a great choice—a master surgeon but more importantly a “mensch.” For those who are not current with the term mensch, it comes from the German language and it means “human being” But it has been used primarily to describe an individual who strives to go above and beyond, demonstrating for instance dexterity in the operating room, professional discipline, and/or forward thinking” What the term mensch really describes is a human being that represents the highest standards of kindness and compassion—someone to admire and emulate. Dr. Kelvin Higa is a devoted father and husband. He is also a great friend whom I consider myself lucky to have. Congrats to Gloria and the whole Higa family on the award. We are looking forward to seeing you in San Diego, California at the annual meeting of the ASMBS and giving Dr. Higa a big round of applause.
Source: bariatrictimes.com

THE Consortium: HRSA Message Regarding the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program

HRSA Administrator Mary Wakefield, together with the heads of the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), recently co-signed a letter to encourage eligible professionals and hospitals in the safety net community to take advantage of the incentive payments under the Medicare and Medicaid Electronic Health Records (EHR) Incentive Program. 
Source: blogspot.com

How medical billing consultants are crucial to Credentialing with Medicare & Medicaid?

Medicalbillersandcoders.com (www.medicalbillersandcoders.com) – by virtue of credible source for Credentialing with Medicare, Medicaid, and prominent private insurance providers – should be physicians’ preferential choice for outsourced Credentialing services. Our process follows tried and tested path: clients set up their account with our firm by utilizing our secure online form. Once the form is submitted, we will obtain the credentialing documentation from the Insurance providers (Medicare, Medicaid, and private insurance carriers) or directly from the Physicians. Medicalbillersandcoders.com will then set up all complicated, and laborious process till physician offices are credentialed amicably. 
Source: ezinemark.com

“Medicare: Changes in premiums and deductibles for 2010.” March 10, 2010. NYSUT: A Union of Professionals. www.nysut.org

Posted by:  :  Category: Medicare

Deal 3, Table 7: Initiation enter Trick A~ contract taker leads King of Risks by KevinHutchins314For inpatient hospital care covered under Part A, the 2010 deductible is $1,100 each benefit period. (A benefit period begins the first day you enter the hospital and ends when you have not received hospital care for 60 days in a row.) While there is no daily coinsurance for the first 60 days of your hospital stay, during days 61 to 90, you will pay $275 per day. The daily coinsurance for lifetime reserve days will be $550 in 2010. (If you have Part A, you are afforded 60 lifetime reserve days, which you can use to cover one or more hospital stays throughout your life.) If you receive care in a skilled nursing facility in 2010, there is no coinsurance for days 1-20. The daily coinsurance for days 21-100 is $137.50.
Source: nysut.org

Video: Fiscal Responsibility and Reform, Federal Budget, Taxes, and Medicare (2012)

Competition cuts down Medicare fraud

In its report, Medicare said it closely monitored the health of beneficiaries likely to use home equipment in the nine areas involved with the competitive bidding experiment. It then compared the results to data for beneficiaries in other similar areas where competitive bidding has not been instituted yet. Using yardsticks such as emergency room visits and nursing home admissions, it found no significant differences.
Source: fiftyplusadvocate.com

Winners And Losers In Medicare Advantage Extras: Avalere Report

One quarter of Medicare beneficiaries get their care through private Medicare Advantage health plans, which are mostly HMOs and PPOs. If a plan bids less in an area than a government benchmark for traditional Medicare, then it gets a rebate of 75 percent of the difference that it must pass along to seniors in extra benefits or lower cost-sharing. That can translate into lower prescription drug premiums, or it can provide benefits that traditional Medicare doesn’t cover, such as vision and hearing.
Source: kaiserhealthnews.org

Medicare Supplement Plans by Definition

At the year 2010, the National Association of Insurance Commissioners, or NAIC, made major revisions and modifications to the Medicare supplement plans system, including the elimination of plans E, H, I, and the highly-deductible plan J. Such plans are eliminated due to the reason that preventive-care and at-home recovery benefits are eliminated. Without these benefits, plans would have been redundant. However, they added a hospice benefit to all remaining plans, which covers the five percent coinsurance charged for respite care and drugs during hospice care.
Source: new-gen.org

Senior Housing Residents Can Benefit from Walgreens’ Preventive Healthcare Services : Senior Housing News

The Affordable Care Act is shifting the healthcare industry toward a managed care model, and a large part of that is preventive care. In light of that, Walgreens (NYSE:WAG) subsidiary Take Care Health Systems is launching a program for Medicare-eligible seniors to participate in preventive visits and annual wellness visits at clinics across the country as a way to improve healthy outcomes and lower avoidable healthcare costs.
Source: seniorhousingnews.com

Mary Washington’s operating income dropped 50 percent in 2011

The biggest factor in Mary Washington’s downturn last year was the loss of Medicare’s sole community hospital status, Barden said. The Centers for Medicare  and Medicaid Services offers sole-provider status to hospitals that are the only hospitals in large geographic areas. The designation translates into higher Medicare  and Tricare reimbursements for providers.
Source: fredericksburg.com

Ask The Experts: Retirement

A. The reason no one can answer that question is because one size doesn’t fit all. Whether Medicare Part B is right or wrong for you is something you’ll have to figure out for yourself. You’ll have to compare the benefits Part B offers with your other medical coverage. In short, Part B helps cover medically necessary services such as doctors’ services, various kinds of therapy, outpatient care, durable medical equipment, home health services, including part-time and intermittent nursing care, and other medical services. Part B also covers some preventive services. If you find that these benefits fill gaps in your present coverage or enhance those that you can already receive, and it makes financial sense to pay the premiums, sign up for Part B. If not, don’t.
Source: federaltimes.com