Manager of Claims – Medicare – Brentwood Tennessee

Posted by:  :  Category: Medicare

CONGRATULATIONS EVERYBODY RETIRED REPUBLICAN SENATORY ALAN SIMPSON SAYS YOU ARE "THE GREEDIEST GENERATION" by SS&SSOur Brentwood, TN healthcare client is looking for a Manager of Claims to join their fast-paced team on a direct hire basis. Summary: Leads, motivates and manages large, first dollar claims processing and adjudication department. Assures accurate and timely processing of claims, within company guidelines, for all Medicare Advantage products. Duties and Responsibilities: Oversee development, […]
Source: twittdallas.com

Video: Become a Medicare/Medicaid Sales Representative at UnitedHealth Group

Highmark Medicare Services: Careers in Computer Animation

Different approaches are being taught to students who prefer to enroll the course in a prestigious animation school. The school provides high tech tools and latest learning in computer animation. You will be able to widely apply and practice your skills in large and complete laboratory. Computer animation courses include all that you need in the field to get ahead. You may study programs in software, hardware and technologies in creating realistic animation. Learn to develop your skills in creating backgrounds and lighting effects and story lines, textures and characters. Layering techniques, visual effects and articulation of characters is being taught in animation training. After acquiring enough knowledge in animation course, start setting your work plan. You should enhance your skills in computer animation if you want to excel in the field, and now is the time to prove others and to yourself that you will be a great animator.
Source: blogspot.com

The Importance of Physician Advisor Services

The review’s objective was to determine whether the University billed same-day readmissions in accordance with Federal requirements. The following were conducted in conjunction with the review: (1) reviewed applicable Federal laws, regulations, and guidance; (2) extracted the University’s inpatient paid claims data from CMS’s National Claims history file; (3) identified 47 inpatient same-day readmissions; (4) selected 27 readmissions for which the patient was discharged to another provider and subsequently readmitted; (5) reviewed the admission and readmission records, itemized bills and readmission advices; (6) discussed the incorrectly billed readmissions with the University to determine the underlying causes of non-compliance with Medicare requirements; and (7) calculated the correct payments for those readmissions requiring adjustments.
Source: bhmpc.com

Work after Retirement Has Health Benefits: Find a Job after 65 and Stay Healthier, Study Finds

Working with the seniors I have found many that have full capacity and with this and they are willing they would be an asset to any company. With a longer attention span and the many years of using their thinking powers and basically just sage knowledge I see them as a valuable and useful asset in the workplace. So many of he elders sit at home never using their mental capacity which over the years has been trained in many different areas of the knowledge they have learned over time. Any business should consider the experience they can bring to the work setting.
Source: suite101.com

Baby Boomer Retirement: Important Medicare Tips for Boomers

1.  Enroll in Medicare as soon as possible.  You can contact your local Social Security office for an appointment, and sign up while you are there.  You may especially want to handle your application this way if you are also applying for your Social Security benefits at the same time.  However, another choice is to apply for your Medicare benefits online in about 10 minutes by using the government website at www.socialsecurity.gov/medicareonly.  You can complete the application once you are 64 years and 8 months old.  You do NOT want to wait until after your 65th birthday. 2.  If you are still working when you turn 65, and you are covered by a medical insurance plan through your employer, you still need to file for Medicare Parts A and B, even if you will not be using those benefits for a few years.  Again, you need to do this before your 65th birthday, so you can save money on premiums when you do begin to rely on Medicare. 3.  Medicare is divided into four parts:  Original Parts A and B, which help cover hospital and doctor bills; Part C, which is an extra Medicare Advantage program you purchase to cover some of the expenses not covered by A and B; and Part D, which is drug coverage.  When you choose a Medicare Advantage plan, or Part C, most of the plans also include Parts A, B and D so that everything is together in one convenient plan. 4.  There are many different Medicare Advantage plans, and most of them will offer informational meetings in your community.  However, one of my friends simply called her current doctors and asked them which Advantage programs they liked the best.  She found there was one particular plan that kept being mentioned, so that is the Advantage program she chose.  You should also know that there are different prices and benefits available for the various plans, too, so shop around. 5.  If you believe that you cannot afford your Medicare premiums, ask for help from your local Social Security office.  Low income retirees can qualify for help. You are reading from the blog http://baby-boomer-retirement.blogspot.com/ Photo courtesy of http://www.morguefile.com/
Source: blogspot.com

Gov. Scott: Florida will not implement insurance exchanges or expand Medicare

Gov. Rick Scott tells Fox News that he and his Attorney General, Pam Bondi, will work tirelessly to make sure the law is repealed. He feels that can be done by electing officials, like Mitt Romney, who have vowed to fight the law before 2014, when most of its provisions kick in.
Source: foxnews.com

EXPERIENCED MEDICARE BILLER

EXPERIENCED MEDICARE BILLER – HOME HEALTH CARE Fast growing Medicare certified Home Health Agency in Northern Virginia that provides a range of services, including skilled nursing care, therapy services, post-acute medical and rehabilitation care, home health care and rehabilitation therapy has immediate opening for an experienced Medicare billing Specialist. The Medical Biller is responsible for processing Medical billing. Must have comprehensive understanding of the Medicare program, including coverage and entitlement criteria, billing rules, beneficiary rights and provider responsibilities. Skills / Requirements • Minimum of three (3) years experience in billing for a skilled home health agency or facility. • Previous exposure to automated tasking system preferred. Ability to manage, analyze and reconcile billing and payment detail, including ICD-9 Coding. • Ability to work well in a team-oriented, cooperative environment. Professional demeanor and ability to provide excellent customer service. • Computer skills including working knowledge of Excel and Word. • Knowledge of daily processes for managing home health accounts receivable. • Knowledge of Allscript system and of all county, state, federal or third party rules and regulations relating to home health accounts receivable such as Medicare, Medicaid and Managed Care preferred. Turn your skills into the rewards of helping people and get: • competitive salary • convenient location • ongoing training and support • great team-focused work environment • benefits • work/life balance • the pride of working for a leader CLICK HERE TO APPLY or e-mail resume and cover letter to inquiry-health@usa.net or fax to 703-549-3178
Source: retirement-living.com

11 Consequences for Employers of Affordable Care Act

Posted by:  :  Category: Medicare

OBAMAS DEATH PANEL------ GUESS WHAT FOLKS IT'S ALIVE AND WELL---"CRAZY PALIN" NOT SO CRAZY NOW by SS&SS6. Play or Pay. Beginning in 2014, employers with 50 or more full-time employees will have to either (a) provide at least a specified minimum level of health coverage that its employees can afford or (b) pay a shared responsibility payment.  This payment amounts to a penalty of $2,000 per full-time employee (not including the first 30.)  While that’s a lot less than the cost of health insurance, think carefully about all the implications (such as recruiting and retention) before deciding to drop health insurance for your employees.
Source: franchise-info.ca

Video: Spring Medtrade 2009 VistaCast Episode 1

Free Health Insurance U.S.

Free Health Insurance is owned and operated by Barry White, a former Health Insurance Specialist with 16 years experience in the health insurance industry. Mr. White now dedicates his time to helping families find affordable insurance in a quickly changing marketplace. He provides this quoting service free of charge to consumers, and makes no commissions from any insurance company or agent.
Source: freehealthinsurance.us

Employers and Medicare: Creating a Win

Employers and Medicare: Creating A Win-Win” is a unique, online Audio Visual educational seminar designed for Employers to help them understand Medicare and how Medicare contrasts with their group medical program.  The education seminar is on the website, www.turning65seminar.com, which features several other Medicare Audio Visual educational seminars.  All the seminars are available 24/7 on demand and for free.  The website was created by Beta Benefits Insurance Services,Santa Ana, to help Medicare eligible members understand the Medicare Program.
Source: advancedplanning4docs.com

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

Sometime ago, when medical practices had only to deal with either the Federal Government sponsored Medicare or state-wise Medicaid schemes, the process of getting Credentialed was seemingly manageable by physicians themselves. But, as the healthcare industry opened up to private insurance carriers, the task got a bit heavier as they had to deal with multiple insurance carriers along with Medicare and Medicaid. As physicians were treated to a multiple portfolio of reimbursement sources, they started to feel a decline in their ability to bargain positively with these multiple sources. Consequently, this started to reflect negatively on their revenue generation. Eventually, they had no recourse but to opt for specialized Credentialing services from medical billing companies.
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

What Anesthesiologists Should Know About Medicare Prepayment Reviews

During 2011, CMS recovered $5.6 billion in fraudulent payments, an increase of 167 percent over 2008. The increase in recoveries is attributable in major part to the $350 million allocated through the Affordable Care Act over 10 years to ramp up anti-fraud efforts. The ramp-up has involved, thus far, more “feet on the street” law enforcement agents, and also investments in sophisticated data analytics allowing more prepayment scrutiny. Since June 30th, CMS has been using predictive modeling to help identify potentially fraudulent claims and the providers and suppliers who routinely submit such claims.
Source: beckersasc.com

Additional Medicare Tax Guidance For Employers from the IRS

Posted by:  :  Category: Medicare

Healthcare solution >> more doctors by / // /If a former employee receives group-term life insurance coverage in excess of $50,000 and the resulting income is in excess of $200,000, how does an employer report Additional Medicare Tax on this? The imputed cost of coverage in excess of $50,000 is subject to social security and Medicare taxes, and to the extent that in combination with other wages it exceeds $200,000, it is also subject to Additional Medicare Tax. When group-term life insurance over $50,000 is provided to an employee (including retirees) after his or her termination, the employee share of social security and Medicare taxes and Additional Medicare Tax on that period of coverage is paid by the former employee with his or her tax return and is not collected by the employer. An employer should report this income as wages on Form 941, Employer’s QUARTERLY Federal Tax Return (or the employer’s applicable employment tax return), and make a current period adjustment to reflect any uncollected employee social security, Medicare, or Additional Medicare Tax on group-term life insurance. However, unlike the uncollected portion of the regular (1.45%) Medicare tax, an employer may not report the uncollected Additional Medicare Tax in box 12 of Form W-2 with code N.
Source: somersetblogs.com

Video: Medicare and the Federal Employees Health Benefits (FEHB) Program

Practical Insights: Dealing with Medicare Part B and COBRA Coverage

Generally, the Socal Security Act provides that individuals may enroll in Medicare Part B (which covers doctors visits and other outpatient services) when they reach age 65. If they fail to do so during a seven-month initial enrollment period surrounding their 65th birthday, they can enroll during an annual “general enrollment” period that occurs each January 1- March 31, with coverage becoming effective the following July1, though they will incur a penalty in the form of permanently higher Part B premiums (10% increase for each year of available coverage that is foregone). However, actively employed individuals who have employer-provided health coverage can postpone signing up for Medicare Part B until after age 65. When they lose the employer-provided coverage or terminate employment, whichever happens first, they are then provided an eight-month “special enrollment period” (“SEP”) during which they can sign up for Medicare effective immediately and without penalty.
Source: fordharrison.com

Tax Updates for Colleges and Universities from The Tax Translator, Steve Hoffman: Medicare Tax Increase

The tax is in addition to the regular Medicare rate of 1.45% on wages received by employees with respect to employment. The tax only applies to the employee portion of the Medicare tax. The employer Medicare tax rate remains at 1.45%. There will be an additional line will be added to the 2013 Form 941, Employer’s Quarterly Federal Tax Return, to report this tax. However, Form W-2 will not be revised. All employee Medicare tax withholding will continue to be reported in box 6 of Form W-2.
Source: blogspot.com

New York Public Personnel Law: Employer’s reimbursement of Medicare Part B premiums is a “term and condition of employment” subject to mandatory negotiation

The court explained that such health insurance benefits, although paid after retirement, constitute a form of compensation earned by the employee while employed. Thus, noted the Appellate Division, as the Court of Appeals has held, and PERB rationally concluded, here that Chenango Forks “ha[d] a duty to negotiate with the bargaining representative of current employees regarding any change in a past practice affecting their own retirement health benefits,” citing Matter of Aeneas McDonald Police Benevolent Assn. v City of Geneva, 92 NY2d at 332 [emphasis omitted]; see Matter of Incorporated Vil. of Lynbrook v New York State Pub. Empl. Relations Bd., 48 NY2d at 404; Matter of Jefferson-Lewis-Hamilton-Herkimer-Oneida BOCES [JLHHO BOCES Professional Assn.], 219 AD2d at 802; Matter of Corinth Cent. School Dist. [Corinth Teachers Assn.], 77 AD2d 366, 367 [1980], lv denied 53 NY2d 602 [1981].
Source: blogspot.com

Q1medicare.com Estimated Value $5,702.40 USD

Posted by:  :  Category: Medicare

Registrant: q1group llc Post Office Box 840007 St. Augustine, FL 32080-0007 US Domain name: Q1MEDICARE.COM Administrative Contact: Johnson, Susan sjohnson@q1group.com Post Office Box 840007 St. Augustine, FL 32080-0007 US +1.9044618994 Fax: Technical Contact: Johnson, Susan sjohnson@q1group.com Post Office Box 840007 St. Augustine, FL 32080-0007 US +1.9044618994 Fax: Registrar of Record: MISK.COM Record last updated on 2012-Feb-26. Record expires on 2018-Dec-03. Record created on 2008-Dec-03. Domain servers in listed order: DNS.PAIR.COM NS0.NS0.COM The Data in the Misk.com Registrar WHOIS database is provided to you by Misk.com for information purposes only, and may be used to assist you in obtaining information about or related to a domain name’s registration record. Misk.com makes this information available “as is,” and does not guarantee its accuracy. By submitting a WHOIS query, you agree that you will use this data only for lawful purposes and that, under no circumstances will you use this data to: a) allow, enable, or otherwise support the transmission by e-mail, telephone, or facsimile of mass, unsolicited, commercial advertising or solicitations to entities other than the data recipient’s own existing customers; or (b) enable high volume, automated, electronic processes that send queries or data to the systems of any Registry Operator or ICANN-Accredited registrar, except as reasonably necessary to register domain names or modify existing registrations. The compilation, repackaging, dissemination or other use of this Data is expressly prohibited without the prior written consent of Misk.com. Misk.com reserves the right to terminate your access to the Misk.com WHOIS database in its sole discretion, including without limitation, for excessive querying of the WHOIS database or for failure to otherwise abide by this policy. Misk.com reserves the right to modify these terms at any time. By submitting this query, you agree to abide by these terms. NOTE: THE WHOIS DATABASE IS A CONTACT DATABASE ONLY. LACK OF A DOMAIN RECORD DOES NOT SIGNIFY DOMAIN AVAILABILITY.”;
Source: widestat.com

Video: Is Freedom Blue PPO a Medicare Supplement?

403 FORBIDDEN : LOGGED TO HONEYPOT

Your connection details: Record #: 49559 Time: Fri, 06 Jul 2012 15:00:11 -0500 Running: 0.4.10a2 Host: gator1793.hostgator.com IP: 50.97.96.123 Post: Query: Stripped Query: Referer: User Agent: spider Reconstructed URL: http:// pdfbin.net /2011-formulary-list-of-covered-drugs     Generated by ZB Block 0.4.10a2
Source: pdfbin.net

California Medicare Insurance: Anthem Medicare Preferred PPO Replaces Freedom Blue for 2012

One of the newest Medicare Advantage plan in California for 2012 is the Anthem Medicare Preferred Standard PPO or AMP. The Anthem Medicare Preferred is the newest successor to the Freedom Blue Regional PPO plan that became very popular over the past few years. The plan offers significant freedom of choice in regards to your medical service providers. The AMP PPO plan is only available in select counties throughout California and the benefits are different from county to the next. The plans are grouped below by counties that share the same benefits:
Source: blogspot.com

Review of the New Anthem Medicare PPO

“Lasik Surgery Washington DC. People are searching the best services of Lasik Surgery. LASIK is similar to other surgical corrective procedures such as photorefractive keratectomy, PRK, (also called ASA, Advanced Surface Ablation) though it provides benefits such as faster patient recovery.”
Source: lasiksurgerywashingtondc.org

Dave Fluker’s California Health Insurance BLOG: Anthem Medicare Advantage LPPO and Sutter Health Group

Sutter Health Group and Anthem Blue Cross MAPD LPPO (Medicare Preferred PPO and Medicare Preferred Select LPPO) have been unable to reach agreement on a new contract. As of February 1, 2012, Sutter will no longer be a participating provider for Anthem Blue Cross CA hospital and professional network. The ancillary services for Sutter will continue to be a participating provider. Again, this contract issue affects Medicare Advantage PPO and Medicare Advantage LPPO subscribers. The following Sutter Health facilities are affected: Sutter Roseville Medical Center – Roseville, CA Alta Bates Summit Medical Center – Alta Bates/Herrick – Berkeley, CA Alta Bates Summit Medical Center – Summit Campus – Oakland, CA California Pacific Medical Center – California – San Francisco, CA California Pacific Medical Center – Davies – San Francisco, CA California Pacific Medical Center – Pacific -San Francisco, CA California Pacific Medical Center – St. Lukes – San Francisco, CA Eden Hospital Medical Center – Castro Valley, CA Memorial Hospital Medical Center – Modesto – Modesto, CA Memorial Hospital of Los Banos – Los Banos, CA Menlo Park Surgical Hospital – Menlo Park, CA Mills Hospital – San Mateo, CA Novato Community Hospital – Novato, CA Peninsula Hospital & Medical Center – Burlingame, CA San Leandro Hospital – San Leandro, CA Sutter Amador Hospital – Jackson, CA Sutter Auburn Faith Hospital – Auburn, CA Sutter Coast Hospital – Crescent City, CA Sutter Davis Hospital – Davis, CA Sutter Delta Medical Center – Antioch, CA Sutter General Hospital – Sacramento, CA Sutter Lakeside Hospital – Lakeport, CA Sutter Maternity & Surgery Center – Santa Cruz, CA Sutter Medical Center of Santa Rosa – Santa Rosa, CA Sutter Memorial Hospital – Sacramento, CA Sutter Solano Medical Center – Vallejo, CA Sutter Tracy Community Hospital – Tracy, CA I expect that at some point a contract agreement will be reached and will post when that happens.
Source: blogspot.com

July 4th: Kovach Meets Regular Sized Baby Being Held By Giant Baby : Delaware Liberal

Posted by:  :  Category: Medicare

Deputy Administrator and Director for the Center of Medicare at CMS Jonathan Blum visits Christiana Care to speak about accountable care organizations by Christiana CareIf you wish to contact Delaware Liberal, you can do it two ways. The first is to click the Got A Tip link at the top of the page. Or, if you would like to contact a DL contributor directly, just send an email to the contributors name (Cassandra_M, DelawareDem, LiberalGeek, Nemski or Pandora) followed by @delawareliberal.net.
Source: delawareliberal.net

Video: Delaware Medicare Supplements

Medicare Advantage Plans Delaware

There is excellent news for individuals with medigap especially Medicare Part D. As numerous who receive Medicare worry about the changes in their coverage they could be facing, there are some upsides. Medicare Part D drug charges are truly dropping, even as Congress performs to produce health care cuts. Now, the government subsidized prescription strategy will cost seniors an regular of $30 a month, down from $30.76. Even though it may possibly not look like a lot, it comes as a relief to numerous seniors that the strategy is dropping in cost. The Part D drug benefit strategy, began under the Bush administration, allows individuals on Medicare to sign up for privately administered health plans in order to get their prescriptions. It has been wildly popular with seniors, and much less high-priced than the government initially thought. This is in component since company’s that supply personal plans are functioning to win buyers with reduce rates, and also the reduce fees of generic drugs.
Source: oregonmedicarepros.com

Arkansas, Delaware, Montana, New Jersey, New York, North Dakota Launched Their Medicaid EHR Programs This Month

, the Medicaid Electronic Health Record (EHR) Incentive Program launched in Arkansas, Delaware, Montana, New Jersey, New York and North Dakota. This means that eligible professionals (EPs) and eligible hospitals in these six states will be able to complete their incentive program registration. More information about the Medicaid EHR Incentive Program can be found on the Medicare and Medicaid EHR Incentive Program Basics page of the CMS EHR website.
Source: medipro.com

Medigap Advisors Hosts Live Questions and Answers after Healthcare Reform Ruling

[…] Long says, “Millions of newly insured people will be wanting to take advantage of their low-cost benefits, so Medicare actuaries are predicting doctor shortages.” He is concerned that healthcare reform encourages doctors to form Accountable Care Organizations or ACOs. Long warns beneficiaries: “You will not necessarily see the same doctor at each visit, and you will probably not be allowed to get care from doctors outside of the ACO. Because of the way that ACOs are compensated, there are incentives for them to provide less service. It is your responsibility to take an active role in your care, to ask questions and demand the treatment you feel you deserve.”Source: medigapadvisors.com […]
Source: medigapadvisors.com

Highmark Medicare Services Changes Name to Novitas Solutions, Inc.

Please read the following bulletin from Highmark Medicare Services. The affected payers are: CPID 2456 Delaware Medicare CPID 5912 Delaware Medicare CPID 3677 J12 Mutual of Omaha DC,DE,MD,NY,PA CPID 7402 Maryland Medicare CPID 5554 Maryland Medicare CPID 2464 Maryland Medicare (MONTG,PRINCE GEORGE) CPID 1465 New Jersey Medicare CPID 5503 New Jersey Medicare CPID 5598 Pennsylvania Medicare CPID 2457 Pennsylvania Medicare CPID 2461 Virginia Medicare (ALEX,ARLGTN,FAIRFAX) CPID 1522 Washington DC Medicare CPID 2459 Washington DC Medicare Reported by Highmark Medicare Services: As announced March 1, 2012, Highmark Medicare Services is changing its name to Novitas Solutions. Effective March 10, 2012, Highmark Medicare will begin migrating the current Highmark Medicare website to our new Novitas Solutions website. We are targeting completing our name change to all active webpage content by March 30, 2012. The new Novitas Solutions website URL will be https://www.novitas-solutions.com. Additional details, including Frequently Asked Questions, are available at https://www.novitas-solutions.com/partb/info-alerts.html. Re-enrollment is Not required. The clearinghouse will continue processing as normal. If you have any questions, please contact Client Services at 1-888-348-8457, option 2.
Source: collaboratemd.com

High Deductible Medicare Supplement Plan F

Posted by:  :  Category: Medicare

MORE DIRTY TRICKS FROM YOUR SOCIALIST/MARXIST   PRESIDENT AND HIS NASTY LITTLE ADMINISTRATION HACKS by SS&SSThe Medicare supplemental insurance policy labeled high deductible Plan F is a standard plan F plan with a $2070 dollar yearly deductible and a significantly less monthly premium.  When choosing a form of Medicare insurance there are two common alternatives, they are:  Medicare A and B with a Medigap insurance policy or a Medicare Advantage plan.  A Medigap policy is the most popular alternative of these choices.  Once you have decided that a supplemental insurance policy is the best option for your health care needs the choice of which supplement policy comes next.  The Medicare Supplement Plan F is the Medigap policy with the most benefits and provides the best protection from medical bills.  A sometimes forgotten alternative to the plan F is the High Deductible Plan F.  The high F provides the exact same benefits as a standard F plan except it has a $2076 dollar yearly deductible.  The High F plan can be a less costly alternative for individuals that are in good health.
Source: medicare-supplement-advisor.org

Video: Medicare Supplement Plans | Questions about Medicare Supplement Plans

My Article Submission Directory: Why It Is So Important to Choose a Medicare Supplement

Our government has recognized that it is very important to care for its elderly citizens. That is the reason why Medicare health insurance was created. Anyone age 65 or older is eligible for this government health care plan. For many that are eligible, Medicare can be very confusing because it has many parts. To put it simply, Part A covers any costs for impatient hospital care. Most of those who pay Medicare taxes from paychecks receive Part A for free and automatically. Part B includes some doctors’ services and outpatient care-but it is not free. Part B requires a minor monthly premium. Part C deals with various health care options, like HMOs, that are approved by Medicare but are not related. Part C allows for a private insurance company, through a government contract, to reside over all of your Medicare benefits. Part C also requires additional costs that can vary widely. Part D was created to cover prescription drugs. This plan is controlled by private companies that are Medicare-approved. It is also optional and costs more money. The “original” Medicare plan was comprised of only Parts A and B. Later, the “advantage” plans of Parts C and D were added, and with a higher cost. Parts C and D had to be created because parts A and B did not pay for everything. Medicare has created Medicare supplement plans to ensure that all costs can be paid and it is a type of private insurance. Most of the costs these plans cover are deductibles and co-payments that can add up very quickly for seniors on fixed incomes. The supplement plans have been termed “Medigap” because the plans were created to cover the “gaps” in costs for procedures that are not always included in Medicare. Medicare supplement insurance is standardized and regulated by the U.S. government. You can obtain a supplement plan through insurance companies and you must choose which insurance company you want by the price of their supplement plan. This is true because each plan covers the same things-no matter what insurance company you receive it through. “Medigap” insurance is regulated by the Federal government and insurance companies must also follow state laws. Due to different laws, the plans can vary slightly state by state. To add to the complexity of Medicare, there are 12 different types of standardized Medicare supplement insurance. They are designated letters of A through L, so it can take a great amount of time to figure out which supplement plan fits your needs. Sadly, many Americans do not receive health insurance. This dilemma is often due to high insurance rates and prolonged, or even small, illnesses that can clean out an underinsured person’s savings. This results in medical bills that may never be paid off. The key is to have a plan in these situations. Even with the outrageous healthcare costs in this country, it is vital to plan properly if you were to need medical attention. No insurance that is truly affordable will ever be able to cover all healthcare costs. So, you must evaluate your circumstances and your anticipated needs. Due to the fact that medical needs may come up suddenly, it is recommended that you obtain Medicare supplemental insurance.
Source: blogspot.com

MEDICARE CHOICES Independent Insurance Agent dba

CATCHING UP TO THE PRESENT: A BRIEF SYNOPSIS Much has occurred since I last posted to this Blog, not the least of which has been passage of the “Obomneycare Legislation” and it’s judicial “ratification” by the Supreme Court. There are many kinks to work out in the implementation of healthcare reform as legislated by Congress, signed by the President, and upheld by the Supreme Court last week. Despite the contentious process that has brought us to this day, it is the opinion of this independent insurance agent that much good may come of this legislation. As the healthcare industry stabilizes, as the healthcare infrastructure modernizes and expands, as access to healthcare equalizes, as capital and discretionary income become available for economic growth and improved living standards, then the negatives propagandized by the Left Wing and Right Wing demagogues will fade into oblivion. On a personal note I underwent major cardiovascular surgery in April of 2011. This experience has been and continues to be a major change to my life. On the plus side I cannot say enough to express my love, admiration, and gratitude to the two hospitals, their physicians, nurses, physical and occupational therapists, and entire staffs, all of whom work so hard and with so much love, and who saved my life. “My cup runneth over…,” thanks to the Love of God as granted to me through them. The impact of surgery and recovery on my personal and professional life has been great. My spiritual heart opens to the world more and more every day, as do my eyes and my ears. Even though I must now rebuild my fledgling business, like a bird fallen from it’s nest learning to fly again, I do so with a greater sense of the realities of life that center so importantly on healthcare and so specifically on the importance of proper and appropriate health insurance. It is already summer 2012. The 2013-AEP (annual enrollment period) for Medicare is close enough now that insurance providers are now making 2013 training available. More on that next time I post, and for now, may the Good Lord shine His Countenance upon you, protect you, and infuse your soul with His Peace.
Source: blogspot.com

Central States Indemnity Medicare Insurance

Berkshire Hathaway is of course the large investment conglomerate run by none other than Warren Buffett.  In 1992, Berkshire acquired Central States and due to the immense resources behind such a well respect holding company, CSI is afforded an extremely high rating for a midsize Medicare supplement provider.
Source: ohioinsureplan.com

5 Medigap Myths You Don’t Want To Fall For

Myth #2: Like other Medicare plans, you can only change Medigap plans during the annual enrollment period. Fact: Many people are fooled by this myth because it seems very believable. There are only certain times when Medicare enrollees can select or drop Advantage or Prescription Drug plans, so wouldn’t it make sense that Medigap plans are the same way. In reality, Medigap plans do not have this same constraint. A Medigap beneficiary may change their coverage at any time for any reason during the year. However, it is important to note that there are specific periods of time where you can avoid answering medical questions that could exclude you from a Medigap plan. Open enrollment is the most known of these time periods and it occurs in the six month span after you turn sixty five and receive part B of Medicare. There are also “guaranteed issue” periods that come into play after specific events, like losing coverage from an employer or moving to another state. You can still change Medigap coverage at any point in time during the year, but if you are looking to avoid answering any medical questions, stick to open enrollment.
Source: medicaresolutions.com

Epic Insurance: Medicare Supplement Insurance coverage

Medicare Supplement Insurance coverage – What You Need to have To Know As a general rule, Medicare supplement insurance will cover up to 80% of certain varieties of health-related treatments, hospitalizations, medical equipment and so on. The exact quantity of cover will rely on whether you have solely Medicare Part A coverage or whether you have opted for optional Component b coverage as properly. Even with additional Element B coverage a lot of folks are still forced to pay out substantial out of pocket expenses to cover the remaining twenty% not covered by Medicare. This gap is referred to as the co-payment sum and quite frequently individuals just do not have the cash to pay it in cash. There are a range of Medicare supplement insurance policies, or medigap as they are typically known as on the marketplace, exclusively created to aid individuals pay the co-payment sum and despite the fact that they could be managed by diverse businesses, every policy must fall beneath the tips of Medicare. There are currently twelve present standardized Medicare supplement insurance coverage plans which are also referred to as Medigap. The plans are labeled ‘A’ via to ‘L’ and offer various advantages at varying costs based on the co-payment required by the user. Even though the degree and kind of cover supplied in every single plan differs, each and every Medigap strategy should give simple Medicare benefits as a minimum. There is also an additional alternative obtainable known as Medicare Select which is a Medicare supplement insurance coverage policy that is much less high-priced than other plans. The only drawback to Medicare Select is that you are restricted to specified physicians and hospitals for your wellness care needs. The positive aspects inside of each and every of the twelve Medigap plans do not differ from firm to organization if you buy a plan ‘A’, it will be identical no matter which company you use. Nonetheless, premiums can fluctuate significantly from business to firm and paying a higher premium will not make sure that you obtain something more than and over what is integrated in the standardized strategy. The finest time to get a Medicare supplement insurance coverage policy is during the first 6 months after enrolling in Medicare Component B. This is the only circumstance where Insurers are obliged to accept you regardless of any pre-existing well being conditions. Premiums for Medigap policies are set by the following strategies Attained age: This creates the lowest premiums, specifically for those just turned 65. Even so, premiums do boost as you get older, usually every single one, three or 5 years, extremely usually reaching their highest point when you can least afford them. Issue age: Premiums are based on your age at the time of acquire and will not improve as you get older. Neighborhood-rated: Everybody in the identical geographic area pays the very same premium regardless of age. It must be noted that every January 1st Medicare’s rewards are adjusted to keep up with inflation and as all Medigap positive aspects are co-ordinated with Medicare’s, premiums for Medicare supplement insurance plans normally enhance each year above and over any increases described above. Our site has a massive sum of up to date details about medigap expense and crucial medicare concerns. Keep informed on this crucial issue.
Source: blogspot.com

Medicare Supplement or Medicare Advantage? Which is Best?

As you’ve probably realized from reading that last bullet point, Medicare Advantage plans are usually less expensive than Supplement plans. So, if you’re willing to deal with the restricted network (i.e., you don’t plan on being a perpetual globetrotter) and your funds are limited, the Medicare Advantage plan may be the best choice for you. But, of course, there are other very important factors beyond monthly cost that you should be aware of.
Source: elevateseniorlife.com

Medicare Supplement Quotes, When Should You Get Them?

If you think you are healthy enough to not require more coverage than Medicare Part A, you should know that not gettting your Medicare Supplement Quotes now will mean paying a penalty later. For instance, lets say you choose to not but any Medicare Supplement Plan until you are 70. Then when you do get your Medicare Supplement Quotes, you will need to pay 50% more premium (10% per year since you turned 65) than your peers. 
Source: benepath.com

Medigap Advisors Hosts Live Questions and Answers after Healthcare Reform Ruling

Posted by:  :  Category: Medicare

Long says, “Millions of newly insured people will be wanting to take advantage of their low-cost benefits, so Medicare actuaries are predicting doctor shortages.” He is concerned that healthcare reform encourages doctors to form Accountable Care Organizations or ACOs. Long warns beneficiaries: “You will not necessarily see the same doctor at each visit, and you will probably not be allowed to get care from doctors outside of the ACO. Because of the way that ACOs are compensated, there are incentives for them to provide less service. It is your responsibility to take an active role in your care, to ask questions and demand the treatment you feel you deserve.”
Source: medigapadvisors.com

Video: SHIIP Medicare Enrollment Basics.flv

Research Roundup: Crowded Emergency Departments, Expensive HIV Drugs

RAND: Skin In The Game: How Consumer-Directed Plans Affect The Cost And Use Of Health Care — Consumer-directed health plans, which feature lower premiums and higher deductibles than traditional plans, are designed to reduce costs by discouraging unnecessary care. This brief describes a study of more than 800,000 households that switched from a traditional employer-based plan to a consumer-based plan. Within the first year, families spent 21 percent less on care; about a third of the reduction was attributed to less spending per care episode, while two-thirds was attributed to fewer episodes total. Families also, however, sought less preventive care — including childhood vaccinations, mammograms and blood tests. The authors caution that if “patients skimp on highly valuable services that can prevent more costly problems later, the savings [from consumer-directed plans] may be short-lived” (Haviland et al, 6/28). Journal of the American Medical Association: Duplicate Federal Payments For Dual Enrollees In Medicare Advantage Plans And The Veterans Affairs Health Care System — The Veterans Affairs system is allowed to bill private health plans for the care it provides to enrollees, but it is not allowed to bill privately run Medicare Advantage plans. This sets up the potential for redundant federal spending as elderly veterans enrolled in an MA plan also visit a VA facility. Researchers in this study found that, from the beginning of 2004 until the end of 2009, more than 1.2 million veterans were enrolled for at least a month in both the VA and a Medicare Advantage plan, and VA spending for the dual enrollees totaled $13 billion. The authors encourage policymakers to “monitor the use of VA services among MA-enrolled veterans and modify payments to MA plans accordingly” (Trevidi et al, 6/26). RAND: Negotiation Strategies For Antiretroviral Drug Purchasers In The United States — Antiretroviral drugs continue to be inaccessible and unaffordable for many low-income individuals, and despite the government’s leverage through Medicaid and other programs, new strategies are needed for price negotiation with manufacturers. This report looks at several options, including improved price transparency and switching people dually eligible for Medicare Part D and Medicaid to the latter program, which pays less for these antiretroviral drugs. The authors also propose pooling individual states and groups to increase their drug purchasing power. With “greater consolidation of public programs and increased demand for drugs through universal coverage,” they note, “public programs might be in a better position to negotiate drug prices” in the future (Linnemayr et al, 6/29). Annals of Emergency Medicine: National Trends In Emergency Department Occupancy, 2001 to 2008: Effect Of Inpatient Admissions Versus Emergency Department Practice Intensity — Emergency department crowding can lead to lower patient satisfaction and adverse outcomes. In this study, researchers used federal survey data from 2001 to 2008 and estimated that the number of ED visits increased nearly 2 percent each year, and average occupancy increased more than 3 percent each year. One of the main drivers of crowding was intensity of care, with patients receiving more imaging tests and services, which significantly extended their stays. The data also showed Medicare beneficiaries had increasingly frequent visits, which could be attributed to poor access to primary care. Overall, the authors write, “ED crowding is probably getting worse, not better” (Pitts et al, 6/22).
Source: kaiserhealthnews.org

Romney Lies About Medicare/Medicaid Change Of Address Form

There were periods during my government service when the business-does-it-this-way was fashionable.  Public private partnership (acronym PPP) became popular.  At some point what tended to happen or be realized was the understanding that the public service does not have, cannot have the same “bottom line” as a for-profit organization.  Wall Street exemplifies the outsize for-profit situation these days…I do not think most people want the government to emulate that value system when it comes to exercising government authority.  And, frankly, when you look at it, the basic myth at bottom of the business school takeaway about efficiency has a lot of flaws…not the least of which is that large, major corporations with their overpayment of failing executives and with their taking-care-of-the-top first motif are the opposite of even the the narrowest definition of “efficiency.”  
Source: talkleft.com

Obamacare Is Good for Medicare

Opponents of the Independent Payment Advisory Board have put out misleading information on the program, saying that it will ration care or reduce benefits to enrollees. But in reality there are protections in the Affordable Care Act to guard seniors from exactly those situations, which is why the board is a good way to cut costs while keeping Medicare intact. And though the final decision whether to institute the board’s recommendations rests with Congress, the board is essential to reducing the rate of long-term growth in Medicare—without it, the federal deficit and other long-term debt would increase in the next decade.
Source: potusnews.net

MEDICARE CHOICES Independent Insurance Agent dba

CATCHING UP TO THE PRESENT: A BRIEF SYNOPSIS Much has occurred since I last posted to this Blog, not the least of which has been passage of the “Obomneycare Legislation” and it’s judicial “ratification” by the Supreme Court. There are many kinks to work out in the implementation of healthcare reform as legislated by Congress, signed by the President, and upheld by the Supreme Court last week. Despite the contentious process that has brought us to this day, it is the opinion of this independent insurance agent that much good may come of this legislation. As the healthcare industry stabilizes, as the healthcare infrastructure modernizes and expands, as access to healthcare equalizes, as capital and discretionary income become available for economic growth and improved living standards, then the negatives propagandized by the Left Wing and Right Wing demagogues will fade into oblivion. On a personal note I underwent major cardiovascular surgery in April of 2011. This experience has been and continues to be a major change to my life. On the plus side I cannot say enough to express my love, admiration, and gratitude to the two hospitals, their physicians, nurses, physical and occupational therapists, and entire staffs, all of whom work so hard and with so much love, and who saved my life. “My cup runneth over…,” thanks to the Love of God as granted to me through them. The impact of surgery and recovery on my personal and professional life has been great. My spiritual heart opens to the world more and more every day, as do my eyes and my ears. Even though I must now rebuild my fledgling business, like a bird fallen from it’s nest learning to fly again, I do so with a greater sense of the realities of life that center so importantly on healthcare and so specifically on the importance of proper and appropriate health insurance. It is already summer 2012. The 2013-AEP (annual enrollment period) for Medicare is close enough now that insurance providers are now making 2013 training available. More on that next time I post, and for now, may the Good Lord shine His Countenance upon you, protect you, and infuse your soul with His Peace.
Source: blogspot.com

Marci’s Medicare Answers, www.MedicareRights.org

Dear Alfred, If you do not enroll in the Medicare prescription drug benefit (Part D) when you first become eligible, and you choose to enroll at a later date, you may have to pay a premium penalty. The premium penalty will be 1 percent for every month you delay enrollment (1 percent of the national base beneficiary premium). For example, the national base beneficiary premium in 2012 is $31.08 a month. If you delayed enrollment for seven months, your monthly premium penalty would be $2.18 ($31.08 x 1% = $0.3108 x 7 = $2.18), which will be added to your plan’s monthly premium.
Source: homeboundresources.com

Medicare Provider Enrollment: Revalidation Required: Michigan Attorneys

Health care reform law requires that providers who enrolled in Medicare prior to March 25, 2011, submit enrollment revalidation information upon request by the Centers for Medicare and Medicaid Services ("CMS") or its contractors.  Any provider that fails to submit the requested revalidation information within 60 days of receiving such a request risks interruption or deactivation of Medicare billing privileges.  Revalidation for all providers who enrolled in Medicare prior to the above date will occur between now and March of 2015 on a steady basis.  Providers can check the lists provided at CMS’s website to determine if they were already sent a revalidation notice that was perhaps overlooked in the mail.
Source: healthlawyersblog.com

Major Improvements to Medicare Online Enrollment System

5010 ABC Home Health Care Inc. accountable care organizations Agency for Health Care Administration AHCA quarterly report Amedisys Barack Obama Bill Nelson Centers for Medicare & Medicaid Services Cliff Stearns companionship services exemption ContinuLink Department of Health and Human Services Department of Justice Department of Labor Elizabeth Hogue F2F Fair Labor Standards Act Federal Bureau of Investigation Florida Home Health Care Providers Inc. Gentiva Health Services Health Care Fraud Prevention and Enforcement Action Team (HEAT) HH CAHPS Hilda Solis HIPAA ICD-10 In-Home Aides-Partners in Quality Care Independence at Home Demonstration Kathleen Sebelius Lisa Remington Marco Rubio Marilyn Tavenner Medicare Fraud Strike Force MedPAC National Association for Home Care & Hospice National Private Duty Association Office of the Inspector General Open Door Forum Palmetto GBA Pam Bondi Patient Protection and Affordable Care Act PECOS Rick Scott Super Committee Supreme Court
Source: hcafnews.com

a Blog on Medical Billing, Coding, Reimbursement and Health Care Office Management: Medicare Enrollment Form CMS

Medicare Enrollment Form CMS-855 Are Now Being Accepted 60 Days Prior to Effective Date! This is a good news for all Part B physicians! Because this used to be a 30 days time frame! Now, you have 60 days in advance to file your physician’s enrollment application before the effective date or “start date” at a new medical practice office. So if for instance, you have a start date at a new practice of August 1st, you have 60 days before the 1st of August to submit the enrollment application. Read more about this new change from Medicare Learning Network Matters
Source: medicalcodingandbillingblog.com

Healthways Announces Partnership with Anytime Fitness for SilverSneakers and Prime Fitness Programs

Posted by:  :  Category: Medicare

Healthways (HWAY) is the largest independent global provider of well-being improvement solutions. Dedicated to creating a healthier world one person at a time, the Company uses the science of behavior change to produce and measure positive change in well-being for our customers, which include employers, integrated health systems, hospitals, physicians, health plans, communities and government entities. We provide highly specific and personalized support for each individual and their team of experts to optimize each participant’s health and productivity and to reduce health-related costs. Results are achieved by addressing longitudinal health risks and care needs of everyone in a given population. The Company has scaled its proprietary technology infrastructure and delivery capabilities developed over 30 years and now serves approximately 40 million people on four continents. Learn more at www.healthways.com.
Source: gymrat-fitness.com

Video: Silver Sneakers class at the Carl H. Lindner YMCA

Silver Sneakers at the Carl H. Lindner YMCA

I hope you obtain new knowledge about . Where you possibly can put to easy use in your life. And just remember. View Related articles associated with Medicare Supplement . I Roll below. I even have recommended my friends to help share the Facebook Twitter Like Tweet. Can you share Silver Sneakers at the Carl H. Lindner YMCA.
Source: blogspot.com

SilverSneakers Offers Free Gym Memberships: Seniors Benefit From Quality Group Exercise for Older Adults

People who wish to improve their health through focused exercises specially designed to meet the needs of older adults may wish to participate in the SilverSneakers Fitness Program. Those who qualify may enjoy a free membership to a participating fitness center, but other members of the gym may also take SilverSneakers classes at that facility. With a variety of group exercise classes offered on land and in the water that are taught by certified instructors, participants can enjoy exercising in a positive social atmosphere that can meet the needs of seniors of varying levels of fitness.
Source: suite101.com

Silver Sneakers Fitness Program for Seniors: Physical Activity Bonus for Senior Citizens in Some Medicare Plans

Queens Rose, I think that Silver Sneakers is a great program for seniors and I’m very happy to have it! I am now 66 and althought I can not think of myself as a senior, am going to Silver Sneakers because my insurance is paying for it and My family and doctor think it will be good to get rid of my Colesterol! I really like Silver Splash although I must wash my hair every time I go and take one of those classes, to get rid of the choreine in the water! All and all it gives me something to do and the people are wonderful!
Source: suite101.com

How Medicare Supplement Plans Work

In future anything can take place with us. As a result we ought to be mindful and cautious in the quite fact. Correct means of having precaution will be the only to have this difficulty solved. The introduction of insurance in our lifestyle may be the method of counter every one of the unknown undesired accident of our lifestyle. You have to become often extremely cautious and every measures with the strategy to counter or fight the unknown occurring must be taken in advance. Here within this article we’ll be discussing to the insurance policies dealing with wellness situation. Portion B covered health care expenditures incurred as a result of outpatient procedures and services. Due to the adjustments during the health care business and also the evolving wants of senior citizens, the Medicare supplemental program was developed. As being a Medicare beneficiary, the possibilities offered by these plans allow you to be covered beyond the unique program’s parameters. Medicare supplemental can be a wellbeing insurance coverage plan offered by private insurance companies to individuals folks, who are over the age of 65 years and beneath of 65 years. There are lots of types of protections that you could decide on from Medicare of your choices and interests. All plans of this category are increasingly more advantageous and supportive and caring to safe the existence happily and progressively. There are numerous acknowledged insurance businesses available inside the market place, so you really should have great understanding and sharp understanding of plans to choose the right alternative from Medicare policies. Importantly, you should create excellent comparison between them, lastly you should select the most effective insurance program for defending the daily life with numerous kinds of benefits. A number of the accepted companies of Medicare supplemental plans provide the “silver sneakers” program to their plan participants. This program helps spend for that costs of well being related services, for example health club memberships and fitness classes. Prior to enrolling, verify that spots as part of your place participate in the plan. Because of this additional characteristic, you could shell out for your plan than those made available by other companies. No matter whether it’s worth the expense for you is a really personal selection. Another aspect to think about is company ratings. Many firms who have increased ratings have higher premiums. You will find as considerably as 12 diverse kinds of plans administrated and sold by various healthcare wellbeing companies. These 12 plans can help you to cover all of the large and small fees which are not covered from the authentic plan. It helps the beneficiary to pay out for all those expenses will not be been integrated below the policy coverage with the authentic Medicare plans. These plans assortment under the letter covers A through L and each and every of them have their own policy coverage. The supplementary insurance coverage plans on the original Medicare, the Medicare supplement Plans would be the best help a single can get for your greater profit in Medicare insurance policies. In reality the Medicare supplement plans had been originally standardized in 1992 and given that then there continues to be twelve Medicare supplement insurance plans to be sold as well as Authentic Medicare. The main function of the Medicare supplement insurance coverage plans is to bridge up the gap among the unique Medicare policy coverage and also the actual health-related bill payable by the beneficiary. Due to this nature from the Medicare supplement insurance plans these plans also came to be called the Medigap insurance plans. Apart from filling up the gap left behind by the Authentic Medicare plans the Medigap policies also supplies several other facilities and worthwhile choices.ses as to which services they intend to lower. It’s well-known that medical doctors and hospitals have a tendency to err to the side of not risking lawsuits. Several of us already have end of life directives to avoid currently being kept alive within a vegetative state that brings us no actual that means. If these are the kinds of health care congress wants to quit, the majority of people would agree. On the other hand, if congress is talking about discouraging procedures that could give folks far more years of worthwhile daily life, then there ought to be opposition. Medicare Supplement Insurance Cuts Face Opposition. According to Mary Beth Senkewicz, Florida’s deputy insurance commissioner, increasing the cost-sharing for Medigap plan holders would violate state and federal laws that require guaranteed renewable benefits. She added that this would lead to “serious confusion” for those who rely on Medigap insurance to protect them from unanticipated medical costs. By limiting coverage, it could potentially discourage people from getting necessary medical care. In addition, the bipartisan National Association of Insurance Commissioners sent a letter opposing these changes.
Source: articlesnatch.com

SilverSneakers Medicare Programs

[…] […] […] […] So, what exactly is SilverSneakers?  SilverSneakers is essentially a gym membership or fitness club membership to participating centers across the country.  You can find participating gyms by going to http://www.silversneakers.com and typing in your zip code.  You can find out if your Medicare plan offers Silver Sneakers by calling 1-888-423-4632.  Here are some of the features offered by SilverSneakers.Source: medicare-plans.net […]Source: medicare-plans.net […]Source: medicare-plans.net […]Source: medicare-plans.net […]
Source: medicare-plans.net

Medicare Supplemental Insurance Companies

Thousands of people are turning 65 every day, and are forced to make difficult decisions regarding Medicare Supplemental Insurance.    In addition to choosing the best plan for your health benefits, you must also choose the company from which you would like to purchase.    One option is to purchase your Medicare Supplement Plan from a well-known company who you may have worked with in the past.  The other option is to make an objective decision based upon benefits, price, and customer service.   The important thing to remember is this decision can have a direct impact on your health and financial stability for the duration of your life.
Source: auto-insurance-data.info

Republican representative’s proposed ACA replacement is naive and simplistic

Posted by:  :  Category: Medicare

THE LITTLE MAN KILLED MEDICARE FOR EVERYBONE by SS&SSThis plan will streamline health-care delivery by replacing hospital insurance, Medigap, prescription-drug programs, Medicare and Medicaid with a simple debit card. Instead of dealing with the notorious restrictions, exclusions and red tape of government-provided health care, participants will be empowered to control their own health care and force insurers and providers to compete for their business. Medicare and Medicaid beneficiaries will be freed from these failing, regimented programs, and they will gain the same access and choice in health care enjoyed by other Americans.
Source: medcitynews.com

Video: Medicare Supplement vs. Medicare Advantage Plans – A Doctor’s Perspective

What’s At Stake For Medicare Beneficiaries In Supreme Court Decision

If the health law goes, so will the funding and authorization for a handful of Medicare experiments aimed at reducing health care costs by better organizing and improving the quality of care. The law includes a pilot project to bundle payments to medical providers so that a single check would cover an episode of care, such as a hip replacement. Other programs are set to test value-based purchasing for medical providers and accountable care organizations.
Source: kaiserhealthnews.org

The Centers for Medicare & Medicaid Services (CMS) covers transcatheter aortic valve replacement (TAVR) under Coverage with Evidence Development (CED)

The research study protocol specifies the method and timing of public release of all prespecified outcomes to be measured including release of outcomes if outcomes are negative or study is terminated early.  The results must be made public within 24 months of the end of data collection.  If a report is planned to be published in a peer reviewed journal, then that initial release may be an abstract that meets the requirements of the International Committee of Medical Journal Editors (http://www.icmje.org).  However a full report of the outcomes must be made public no later than three (3) years after the end of data collection.
Source: pharmaceuticalintelligence.com

Know Your Options of Humana Medicare Plans

Selective Auto Care and Services program offers a wide range of specialized coverage as well as optional coverage and flexible payment options. Lots of coverage is offered at no extra costs. Its coverage includes protection when your employees drive your vehicles and coverage for signs, lights, outdoor pumps, underground tanks and even fuel within tanks. To meet your individual needs, optional coverage is tailored, which includes commercial umbrella, employee benefit liability and pollution cargo coverage. Read more
Source: insurance-how-to.com

Ever Wonder How Much Medicare Pays for Hip and Knee Replacement

Between 1998 and 2007, the Medicare reimbursement rate decreased 21 percent for total hip arthroplasty and 20 percent for total knee arthroplasty, according to the report. The researchers surveyed 1,120 patients in an outpatient office setting, asking patients what they thought orthopedic surgeons should receive for total joint arthroplasty and how much they thought Medicare actually paid surgeons. Patients were also asked the same questions about cardiac surgeons who perform open heart coronary bypass surgery and surgeons who perform appendectomy.
Source: nicholascappello.com

What Are Your Options If Grandpa Must Go Into A Nursing Home?

In my conversations with administrators of nursing homes, I have learned that not all Medicare Advantage plans work the same with nursing homes.  People who opt to use a Medicare Advantage plans must pay special attention to how their plan will work in the event that a nursing home is needed.  If your client elects to use Medicare Advantage to take care of their health care during retirement, make certain they review whatever plan they elect to make certain it will cover what they want.
Source: wordpress.com

Making A Decision On A Medicare Replacement Coverage Option

Scott Kerby is the president of Vertex Insurance.  Vertex Insurance is a leading provider of medicare supplement and advantage plans.  Please visit the website at:  http://www.arizonamedicaresupplementplans.com
Source: wordpress.com

Rerun: Wyden/Ryan Medicare plan is a loser

Posted by:  :  Category: Medicare

Benefit Security Card .. HALF of the U.S live in households that receive government benefits (26 May 2012) ...item 2..Brevard man gets 4 years in Social Security fraud case (Jun 1, 2012 ) ... by marsmet481Ryan and Wyden seem to have a mystical belief that bringing private health plans into Medicare is going to control costs. Where is the evidence for this assertion? Private health plans have done a poor job of controlling costs in the private sector and Medicare Advantage plans cost the taxpayer more money than Medicare fee for service. Not to mention the fact that the white paper places all kinds of requirements on the health plans and “will also require the Centers for Medicare and Medicaid Services (CMS) to actively review marketing practices and benefit adequacy… CMS will… weed out junk plans and unqualified insurers.” Sounds nice, but that means we’ll be stuck with mandated benefits and excessive administrative hoops that will thwart innovation. There is a plan to hold down cost growth to just over GDP growth, and somehow (I’ll be curious to see the mechanism) overruns will be dealt with through “reduced support for the sectors most responsible for cost growth, including providers, drug companies, and means-tested premiums.”
Source: ushealthcrisis.com

Video: Tim Walz (Medicare Payments)

No allocation of Medicare secondary payer claim in PI case

The administrative law judge and the district court rejected that argument and required full reimbursement. The 6th Circuit appellate court affirmed. The court found that the key language under Medicare’s secondary payer statute, 42 U.S.C. § 1395y(b)(2)(B)(ii), was the primary plan’s (Pennyrile’s) responsibility to make payment. The court noted that the 2003 amendments to the statute defined that term. The court found that the scope of the plan’s “responsibility” for the beneficiary’s medical expenses, and the beneficiary’s own resulting obligation to reimburse Medicare, is ultimately defined by the scope of the beneficiary’s own claim against the third party. That was true even if the beneficiary later compromised as to the amount owed on the claim, and even if the third party never admitted liability. The court stated that Hadden did not demand that Pennyrile pay for only 10 percent of his medical expenses incurred as a result of his accident; he demanded that Pennyrile pay for all of the expenses. The court found that choice had consequences, one of which was that Hadden had to reimburse Medicare for those same expenses. (From NAELA eBulletin)
Source: lienresolutiongroup.com

Managing Healthcare Costs: Beware Doctors Who Own Ambulatory Surgery Centers

Health care inflation consistently outpaces economic growth, and threatens to ‘crowd out’ other important societal priorities. This blog addresses efforts to control health care costs. The blog began as an outgrowth of a class at the Harvard School of Public Health, and is open to all. Please join us. Further information is at the bottom of this page
Source: blogspot.com

How Medicare’s Payment System Discourages Quality and Innovation

Patient experience, convenience and quality of care do not effect, or at least significantly effect, clinical reimbursement in the standard, traditional fee-for-service Medicare program. There is therefore no incentive to find ways to create new value in the system.  By law, a physician or hospital cannot charge premium pricing for a Medicare-reimbursed service or procedure. I first notice this while treating patient maybe 15 years ago. A first- or second-year physician, I was treating a patient with a serious lung impairment caused by a blood clot in his pulmonary artery. I was transferring this patient from a poorly run suburban hospital, soon to close,  to arguably the world’s expert on these types of clots at the Brigham and Women’s, which is consistently rated as one of the nation’s ten finest facilities. Medicare was paying both physicians the same fee and both hospitals the same fee.
Source: reason.com

The Importance of Physician Advisor Services

The review’s objective was to determine whether the University billed same-day readmissions in accordance with Federal requirements. The following were conducted in conjunction with the review: (1) reviewed applicable Federal laws, regulations, and guidance; (2) extracted the University’s inpatient paid claims data from CMS’s National Claims history file; (3) identified 47 inpatient same-day readmissions; (4) selected 27 readmissions for which the patient was discharged to another provider and subsequently readmitted; (5) reviewed the admission and readmission records, itemized bills and readmission advices; (6) discussed the incorrectly billed readmissions with the University to determine the underlying causes of non-compliance with Medicare requirements; and (7) calculated the correct payments for those readmissions requiring adjustments.
Source: bhmpc.com

Decoding Your Medical Bill

Meanwhile, about 16 states are developing all-payer claims databases, known as A.P.C.D.s, using pricing information based on claims data collected from insurers, Medicaid and Medicare. And many have plans to create consumer Web sites based on that data,  said Patrick Miller, founder of the A.P.C.D. Council. New Hampshire, Maine and Massachusetts have already created such consumer sites, though the information may not always be as specific or as comprehensive as you may like. For Florida residents, he said he also liked this site which provides pricing information for prescription drugs.
Source: nytimes.com

Understanding the Medicare Payment Schedule

On the other hand, the payment refers to the amount that Medicare has approved as the right reimbursement level for the service that the physician has rendered. Did you get the whole picture? Anyway, for this article fee and payment will be used interchangeably. Why was a Medicare Payment/Fee Schedule made? The primary reason why this schedule was made is to protect Medicare beneficiaries. Before schedules existed, the amount billed by the healthcare providers is the amount that Medicare has to reimburse. However, if Medicare refuses to pay the whole amount, the beneficiary will then shoulder the remaining balance. Thus, without the schedule, beneficiaries are highly responsible for paying the outstanding balances that they have on their medical bills. Fortunately, after the payment schedule was developed, Medicare can control and limit the amount that could be paid to Medicare providers and suppliers for every service they have provided. A little controversy Since 2010 and until today, there are many issues embracing the subject of Medicare Payment Schedule. The United States Congress has considered limiting many of the payments in the schedule of up to 25 percent in order to manage the rising cost of healthcare. This has stirred up the medical community since doctors and suppliers complain of receiving less compensation for their services. Plus, associations are concerned that doctors and suppliers will leave their contracts with Medicare due to this, thus leaving fewer choices to beneficiaries. Since the debate about this issue is so intense, the US Congress has passed a legislation that extends the current schedule until the end of 2011 so that the matter will be scrutinized well.
Source: ezinemark.com

MedPAC Head Testifies on Medicare Payment Biannual Report

Author & journalist Max Holland discusses his book, “Leak: Why Mark Felt Became Deep Throat.” Mark Felt was the FBI assistant director who in 1972 leaked Watergate investigation information to several reporters, including Bob Woodward and Carl Bernstein. Holland argues that contrary to popular notions, Felt selfishly used journalists to discredit FBI director L. Patrick Gray in the hope that he would be appointed to the top spot; and that Nixon’s resignation was an unintended consequence. The Kansas City Public Library hosted this event.
Source: c-span.org

Medicare Payment Schedule for 2012 and Claims Processing Hold

While Congress delayed the 27.4% Medicare fee cut that was to have gone into effect on January 1, 2012, it is important to understand that other payment factors from the Medicare physician payment final rule will affect the 2012 fee schedule. In other words, even though the SGR-driven fee cut was averted for two months the 2012 fee schedule is not the same as the 2011 fee schedule. For example, the conversion factor was changed from $33.9764 to $34.0376. Other changes include: an extension of the floor on the work geographic practice cost index (GPCI); multiple procedure payment logic; electronic prescribing and quality reporting; and corrected relative values for certain services. Therefore, the 2011 schedule is not the schedule that will be implemented in 2012 and the currently posted 2012 schedule (that includes the 27.4% fee cut) is not the schedule that will be implemented.
Source: wordpress.com

Obama Care and Senior Housing Part 3: Senior Housing Wins Under ObamaCare

 –  I think this is the more likely of the two scenarios.  Direct payment by the government to providers will cease to be.  Rather the government will pay those dollars to health plans, who will then manage the care of the people they are responsible for.  This will mean an end to Medicare as we know it today.  Essentially what will happen is everyone will be forced into an HMO type plan,  some will function like true HMO’s and others will look more like preferred provider networks.  I also see the Medicaid system moving in the same direction.
Source: seniorhousingforum.net