ABILITY Network Announces Major Inroads in Simplifying Medicare Billing with ABILITY EASE Now Serving More Than 3,000 Providers : e Yugoslavia

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“Introduced just a little more than a year ago, we are very excited that we’ve averaged seven new Homecare or Hospice agencies a day with ABILITY EASE that are able to more easily work in the Medicare DDE/FISS system to check eligibility, submit a claim, make changes to a claim, track claim status and project receivables. Delivering products that make it easier for our clients to treat patients, provide the care they need, and simplify the reimbursement process for that care is important to us,” said Bud Meadows, ABILITY EVP of Sales and Marketing.
Source: eyugoslavia.com

Video: Adam VS The Man with Adam Kokesh (11/10/10) Happy Birthday Devil Dogs! (1 of 8)

Govt. Inspector Finds 25% of Home Health Agencies Make Inappropriate Medicare Claims

AAHomecare AARP Alliance for Home Health Quality and Innovation Almost Family American Association for Homecare Apria Healthcare Group Bank of America Brookdale Senior Living Care.com Centers for Medicare & Medicaid Services CMS Emeritus Senior Living Employee Benefit Research Institute Ensign Group featured Fidelis Care First Care Home Health Care Gentiva Gentiva Health Services Griffin Home Health HCR Home Care HHS Home Health Depot Home Health International Home Health International Inc. Houston Compassionate Care Jordan Health Services LHC Group Inc LSU Medical Staffing Network Healthcare Medicare Medistar Home Health MedPAC Microsoft National Association for Home Care & Hospice National Association for Home Care and Hospice PACE Paraprofessional Healthcare Institute Partnership for Quality Home Healthcare Partnership for Quality Home Health Care PeopleFirst Homecare PHI Res-Care Inc. Stephenson Entrepreneurship Institute VA
Source: homehealthcarenews.com

In Norfolk, Romney names Paul Ryan his No. 2

Also under Ryan’s bill, which passed the House in 2011 but not the Democratic-controlled Senate, Medicaid would be converted to federal block grants given to states for indigent health care. The legislation would make cuts in other federal programs, including Pell grants and subsidies for high-speed rail. The plan would begin to reduce the nation’s budget deficit but not lead to a balanced budget for decades.
Source: rocknrollcallball.com

Wounded Times: This is what CNN thinks is the biggest problem with Romney picking Ryan?

This is what CNN thinks is the biggest problem with Romney picking Ryan But a serious downside to a Romney-Ryan ticket may be Ryan’s specific policy ideas. Widely lauded in conservative circles, Ryan’s budget plan will become front and center in the campaign. This is especially true for the fundamental restructuring of Medicare as proposed in the plan. Medicare and Social Security are typically viewed as the “third rail” of American politics, and presidential candidates have historically shied away from proposing sweeping changes to these programs. They didn’t seem to think that cutting the VA budget or selling it off to private for profit companies was a big deal. Do they even know about this? They talk about Ryan’s budget but didn’t seem interested in what the rest of his plan has in it. If you want to know why CNN Hit 20-Year Weekday Primetime Low I just may be one example of why that happened. There are millions of Americans just like me. CNN joined in the 24/7 coverage of politics and dropped everything else Americans care about. That isn’t the only problem. They failed to actually report on the rest of the story when they covered politicians. When Mitch McConnell and the Republicans became the party in charge of the congress, he didn’t say their number one job was to put Americans back to work. He said their job was to make President Obama a one term president. Then they began to take the steps to do it. The rest of the country had to pay for their plan to work. If they fixed anything, it wouldn’t be in their best interest but they had to act as if they were doing something to earn their pay checks and their own insurance coverage. So they went after the deficit they had been silent about every year before. Most of us remember the fact two wars were never in the budget but were put on the charge card with no plans on how to ever pay for them. The fact that billions were unaccounted for didn’t matter before. This didn’t matter either. Iraq Banks Billions in Surpluses, GAO Says The United States has appropriated about $48 billion for Iraqi reconstruction since 2003 and has committed all but about $6 billion. They wanted to end the Affordable Care Act, they dubbed “Obamacare” and not fix what they thought was wrong with it. They took the easy way out and said just kill it. While this may have “fired up their base” it would have left millions right back where they were with no way to pay for a doctor visit and adult kids without any insurance up to 26. They complained about the unemployment rate as millions of people were out of work and then made it worse by saying they had to cut the deficit and laid off public employees. They didn’t say their number one job was to take care of veterans even though every day we saw more and more of them suffering without getting the care they not only needed, but earned when they lived up to their promise to defend this nation with their lives. There is a very long list of things they didn’t say was their job and veterans ended up suffering for all of what they didn’t want to do. Veterans usually go into public service. It is in their blood to want to be of service to this country. They become police officers, firefighters and emergency responders. They go into healthcare and they become teachers. They go into public service working for their cities and towns to make them better. What happened? A lot of them lost their jobs with the budget cuts but CNN didn’t seem to think any of this was important to mention. If they mentioned it at all, I missed it and so did most Americans. They didn’t seem interested in the fact that National Guards and Reservists on repeated deployments were coming back home with no jobs and no healthcare since they are not covered unless they are deployed and their families are not covered so if they get sick, they are on their own. FOX Orlando During the time that Marine Cpl. Adam Byler spent his 8 months in Afghanistan, his little girl, Adalynn, was born. When he recently came back home, it was love at first sight. Adalynn Byler was pronounced on Monday evening and was on support in order to allow organ transplant teams to be set up. Her family was very generous in allowing other families to have their prayers/wishes/dreams answered. There are three lives whose futures changed on Tuesday by the forward and outward thinking of the Byler family. But this happens all the time. Instead of CNN covering what is happening to so many military families and veterans, they just put on politicians from both parties to make whatever claims they want to make. Some political coverage is necessary but not as much as they decided to do especially when troops were being killed overseas and veterans right here were suffering, waiting for care they were promised. The only good thing to come out of all of this is there is finally some incentive to hire veterans and companies are taking advantage of it. The unemployment rate for veterans has gone down. It could have gone down a lot lower if cable news stations devoted time to covering them all along. When I go to events, there is always someone with a political point of view, but the majority of the veterans I am with are talking about their lives and what is going on with them as veterans and their kids serving today. I don’t watch CNN much anymore while I gave up on FOX cable news and MSNBC a very long time ago. They act as if politics are all that matters but most of us are fed up with that topic being covered most of the time. Oh, sorry I almost forgot that Anderson Cooper on CNN covers Syria a lot too. UPDATE
Source: blogspot.com

Springhill Group Medical: How to Prevent Medicare Fraud

Posted by:  :  Category: Medicare

No doctor shopping here, buddy by Newtown grafittihttp://trishakolens.posterous.com/springhill-group-medical-how-to-prevent-medic Over the years, Medicare has been proactive in its efforts to bring awareness to Medicare fraud, a national problem that costs the program millions of dollars each year. The Medicare program relies heavily on a number of sources to assist them in the detection and prevention of Medicare fraud including professionals of the healthcare industry. Overview of Medicare Fraud Medicare fraud generally refers to willfully and knowingly billing medical claims in an attempt to defraud the Medicare program for money. Anyone found guilty of Medicare fraud is subject to exclusion from participation in the Medicare program in addition to fines and possibly imprisonment. Most Medicare fraud occurs in these areas: • Billing for DME • Billing for physicians services • Billing for institutional services such as nursing homes, hospitals, hospice, etc. Be Aware of Common Schemes There are four popular Medicare fraud schemes. 1. Medical Equipment Never Provided The most common area of Medicare fraud is billing for Durable Medical Equipment (DME). DME refers to any medical equipment necessary for a patient’s medical or physical condition. It includes wheelchairs, hospital beds, and other equipment of that nature. The provider will bill Medicare for equipment that the patient never received. Mobility scooters have been particularly popular for Medicare fraud schemes. 2. Services Never Performed In this instance, the provider bills for tests, treatment or procedures never performed. This can be added to the list of tests a patient has actually received and never be noticed. A provider may also falsify diagnosis codes in order to add on unnecessary tests or services. 3. Upcoding Charges Misrepresenting a level of service or procedure performed in order to charge more or receive a higher reimbursement rate is considered upcoding. Upcoding also occurs when a service performed is not covered by Medicare but the provider bills a covered service in its place. 4. Unbundling Charges Some services are considered all inclusive. Unbundling is billing for procedures separately that are normally billed as a single charge. For example, a provider bills for two unilateral screening mammograms, instead of billing for 1 bilateral screening mammogram. Medicare Fraud Indicators There are certain indicators that are common in the detection of Medicare fraud. Is your practice: • Routinely waiving copayments and deductibles for Medicare patients without checking for their ability to pay? • Charging higher rates to Medicare patients compared to other persons for similar services? • Missing treatment documentation such as physician or nurses notes? What to Do If I Suspect Fraud? It is your responsibility as a representative of the healthcare industry to be aware of and report any fraudulent activity suspected. If you would like to report suspected Medicare fraud, contact the Department of Health and Human Services or the Office of Inspector General for further assistance. http://springhillmedgroup.com/
Source: fc2.com

Video: Heartland Could be Removed from Medicare list of Providers Saturday

Why Paul Ryan represents a big gamble for Romney

“The president is extraordinarily out of touch with how America’s economy works and with how individuals pursuing their dreams in this country have built America,” he told a Tampa station. “The president thinks that it’s government that should take responsibility for all the successful businesses in this country.”
Source: constitutioncenter.org

States Seek Medicare Data to Keep Fraudulent Providers Out of Medicaid

For example, ambulance companies charge the Medicaid program millions of dollars every month to take elders and adults with disabilities to local emergency rooms. Once they arrive at the hospital, Medicare pays for their bills. Without access to Medicare claims and payment data, states have no way of confirming that those ambulance rides actually ended up at an emergency room. Texas officials recently pieced together enough evidence to find that their Medicaid program had been repeatedly defrauded by ambulance operators who were reimbursed for rides that never occurred.
Source: govtech.com


to avoid the MACs from being overwhelmed.  CMS will mail a letter by the end of August to every provider that billed therapy in 2011 stating which phase the provider will be in.  CMS determined which phase the provider falls into based on specific provider characteristics such as claims volume and payment. CMS will also have a table posted on the CMS website were providers can look up their phase as well.  The phases are below.
Source: functionalpathways.com

The realities of physician compensation in 2012

At MediBid, we restore market forces to medical care. Doctors get to set their own rates based on their training, experience, and outcomes, and patients get to shop for medical care across state lines and international borders. Many times with MediBid, you will find procedures that are more effective than procedures allowed, or covered by health plans. Transparency and competition are the only way to achieve reasonable costs. Many of our employer clients offering group health insurance through MediBid save $5,000 per employee per year. Those are substantial savings. Patients are saving an average of 48% vs. insurance discounted rates, or 80% vs. retail. Contact us for more information.
Source: medibid.com

Health IT Business News Roundup for the Week of August 10, 2012

Randy Fox — former CIO for GE Plastics, GE Supply and GE Energy — has been named vice president and CIO at GE Healthcare; Karim Karti — former regional president and CEO of GE Healthcare — has been named vice president and chief marketing officer at GE Healthcare…Ralph Reyes — founding partner at KLAS Enterprises, a health IT research firm — has been named vice president of sales at ClearDATA, a health care cloud-computing platform and service provider; Jonathan Russell — who formerly held leadership roles at GE Healthcare, Healthcare Management Systems and other health care companies — has been named vice president of sales at ClearDATA…Frank Ingari — former CEO at Essence Healthcare, a Medicare Advantage health plan — has been named CEO at NaviNet, a health care communication network.
Source: ihealthbeat.org

Supporting Every Provider in Delivering Better, More Coordinated, Patient

We want to make sure that healthcare providers interested in forming ACOs have the opportunity to do so.  That’s why we created the Advance Payment Model—to provide entities such as rural and physician-owned organizations that hope to become ACOs in the Medicare Shared Savings Program with the support they need to invest in staff and in health information technology.  They will repay Medicare through savings they achieve.
Source: cms.gov

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Posted by:  :  Category: Medicare

What's In My Bag... by Amy DiannaThe page you are looking for no longer exists. Perhaps you can return back to the site’s homepage and see if you can find what you are looking for. Or, you can try finding it with the information below.
Source: aginginplacenews.com

Video: Boston: Medicare Fraud Summit Law Enforcement Panel

1099 requirements: lost my medicare card Another option is the St. James Club Casino in Momora Bay. It s open 8 pm

The frigate bird is easy to spot, especially the male. During mating season, which ranges from September to February, the male inflates a crimson pouch on his throat to attract the female. lost my medicare card Chicks hatch from December to March and remain in the nest for up to eight months. Another option is the St. James Club Casino in Momora Bay. It s open 8 pm-late (depending on the crowd). 268-460-5000. Table games and slot machines are available to visitors at this newly renovated casino. ECO-RAMBLE & HISTORICAL NOTE Enjoy an eco-ramble with Montpelier’s resident industrial archaeologist to learn more about the history of Nevis. Also of interest to history buffs, Montpelier was the site of the marriage of Admiral Lord Nelson and Fanny Nisbet in 1787. Marigot The best shopping is in the capital lost my medicare card city of Marigot. lost my medicare card A crafts market near the cruise terminal offers jewelry, T-shirts, souvenir items, carvings and paintings (we were especially taken with the Haitian lost my medicare card artwork available here). lost my medicare card Marigot also is home to boutiques open 9 am to 12:30 pm and 3 to 7 pm, which offer liqueurs, cognacs, cigars, crystal, china, jewelry and perfumes, many from France.
Source: blogspot.com

cherry creek towers: stolen medicare card before you leave home. Some items are not bargains. Typically, shops open at 8 or 9 am and remain op

before you leave home. Some items are not bargains. Typically, shops open at 8 or 9 am and remain open until noon, then reopen from 2 to 6 daily. When cruise ships are in port, most shops remain open through the lunch hours. stolen medicare card A meal in Nevis means traditional Caribbean fare such as snapper, grouper, salt fish or even flying fish accompanied by side dishes such as breadfruit, pumpkin, yams and the obligatory rice and (pigeon) peas. Everything will be flavorful and often spicy. Wash down dinner with the local beer or liquor. Eco-Travel St. Barth Adventures ( 590-27-50-79) offers mild to wild guided stolen medicare card tours, including kayaking, hiking and snorkeling. They run trips to the out islands, a 30-minute walk to Secret Beach, cave exploration, cliff diving stolen medicare card excursions and more. Most tours are limited to four people. The French side uses 220 AC, 60 cycles and all appliances made in the US and Canada will require French plug converters and transformers. The Dutch side uses 110 AC. Most hotels offer both voltages and different plug configurations, but bring converters to be safe.
Source: blogspot.com

cherry creek vista pool: stolen medicare card While enjoying the lively, loud, almost chaotic ambience, you lldine on affordable and truly authent

Go down the steps into the flood zone, and stay left, following the roar of the charging river, through the medieval Bleachers stolen medicare card Gate, to the riverbank. Lech Riverbank: This low end of town, the flood zone, wasthe home of those whose work depended on the river bleachers, rafters, and fishermen. The Lech River was in its day anexpressway to Augsburg (about 70 miles to the north). Aroundthe year 1500, the rafters established the first professional guild in F ssen. As F ssen was on the Via Claudia, cargo from Italy passed here en route to big German cities farther north. Rafters wouldassemble rafts, and pile them high with goods or with peopleneeding a lift. If the water was high, they could float all the wayto Augsburg in as little as one day. There they d disassemble their raft and sell off the lumber along with the goods they d carried, then make their way home to raft again. Today you ll see no water sports here, as there s a hydroelectric plant just downstream. While enjoying the lively, loud, almost stolen medicare card chaotic ambience, you lldine on affordable and truly authentic Slovak fare, made withproducts from the pub s own farm. This is a good place to try the Slovak specialty, bryndzov halu ky (described above; 6 9 maindishes, Mon Sat 10:00 24:00, Sun 12:00 24:00, Obchodn 62, tel. 02/5292-6367). $$ Moserhof Hotel has 30 new-feeling rooms plus an elegant dining room (Sb- 52, Db- 88, for these special rates ask for theRick Steves discount when you reserve, extra bed- 35, most rooms have balconies, elevator, restaurant, free parking, Planseestrasse44, tel. 05672/62020, fax 05672/620-2040, www.hotel-moserhof.at, info@hotel-moserhof.at, Hosp family).
Source: blogspot.com

typical job application: medicare card lost (giving shelter to Jewish refugees). When the American soldiersmoved in from Italy, they made the ho

tourists as the Romantic Road. Today, while F ssen is overrunby tourists in the summer, few venture to the back streets.whereyou ll find the real charm. Apart from my self-guided walk (seethe next page) and the City Museum, there s little to do here. It s just a pleasant small town with a big history and lots of hardworking people in the tourist business. City Cruise Line (a.k.a. Stadt Schiff-Fahrt) runs a basic40-minute round-trip river cruise with recorded commentary ( 13, 9/day July Aug, 7/day in June, fewer Sept Oct and April May, no boats Nov March). For a longer cruise, ride to Hellbrunn and return by bus ( 16, 1 2/day April Oct). Boats leave from the old- town side of the river just downstream of the Makartsteg bridge(tel. 0662/8257-6912). While views can be cramped, passengers are treated to a fun finale just before docking, when the captain twirls a fun waltz. (giving shelter to Jewish refugees). When the American soldiersmoved in from Italy, they made the hotel their headquarters. Today, it s still a functioning hotel (see Sleeping and Eating, page 316). It recently hosted Otto von Habsburg, the Man WhoWould Be Emperor, if his great-great-uncle hadn t started and lost World War I. Though Otto could have stayed in the fanciest place in town, he chose this historic, comfortable inn instead. Sleeping: 16 19; Bratislava, 214 215; Breitenwang: 360 361; dorms, 150 151; Ehenbichl, 361 362; F ssen: 329 322; Hall: 316 317; hotel maps, 143, 146 147, 256 257; hotel reservation form, 400; Innsbruck, medicare card lost 311 312; Krems, 188 189; making reservations, 18 19; Mariahilfer Strasse and environs, 145 149, 150 151; Melk, 189 190; Moosstrasse (Salzburg), 262 263; Old Town (Salzburg), 258 260; Pinswang, 363 363; reservations, form for, 400; Reutte: 359 360; Ring, inside the, 141 145; Salzburg, 254 263; Vienna, medicare card lost 141 151; Westbahnhof neighborhood, 149 150. See also Hostels
Source: blogspot.com

Crooks Using Health Care Ruling to Run Phone Scams, Feds Warn

For example, a caller might say that they have the routing number of a person’s bank, and then use that information to get the person to reveal the entire account number. Other times, they have asked for credit card numbers, Social Security numbers, Medicare ID, or other personal information.
Source: typepad.com

Medicare Advantage Enrollment Goes Up As Premium Costs Decline

Posted by:  :  Category: Medicare

The Hill: Report: Enrollment Up, Premiums Down For Medicare Advantage The 2010 healthcare law contained cuts to Medicare Advantage that were strongly opposed by Republicans and insurance companies. The program offers care to seniors through private insurers that contract with the Medicare agency. … The program now covers more than 13 million beneficiaries, or 27 percent of the Medicare population, the report stated. … The law’s cuts to the program are expected to save $136 billion over 10 years (Viebeck, 6/12).
Source: kaiserhealthnews.org

Video: Medicare Advantage Enrollment 2012

Medicare Advantage 2012 Data Spotlight: Enrollment Market Update

This data spotlight examines the growth in private Medicare Advantage plan enrollment in 2012, with a record 13 million Medicare beneficiaries enrolled as of March, representing 27 percent of all Medicare beneficiaries.  Enrollment jumped by more than 1 million enrollees from the previous year and increased in every state except Alaska and New Hampshire.
Source: kff.org

GOP Seeks Answers on Medicare Advantage Bonus Payments, CCIIO

The lawmakers also questioned the administration’s decision last year to house CCIIO within CMS; the center originally was set up as its own office. While HHS maintained the move would improve efficiency, the Republicans said they were concerned that CCIIO could be siphoning money from Medicare and Medicaid. They said the move could be a way for the center to use CMS funding and be protected from legislation aimed at cutting funding from the health reform law (Baker [2], “Healthwatch,”
Source: californiahealthline.org

Report: Enrollment up, premiums down for Medicare Advantage

The Kaiser Family Foundation found that this year, enrollment in the program grew by 10 percent — jumps were seen in all but two states — and that the average premium paid by enrollees dropped by $4. The program now covers more than 13 million beneficiaries, or 27 percent of the Medicare population, the report stated.  In 2010, after the healthcare reform law passed, the Obama administration predicted that Medicare Advantage premiums would fall for enrollees as a result of officials’ negotiations with insurers. This ran contrary to the opinions of lawmakers and some policy experts, according to The New York Times. The law’s cuts to the program are expected to save $136 billion over 10 years. A related project, aimed at moderating pain from the cuts with quality bonuses to MA insurers, has received criticism from federal investigators as being wasteful.
Source: thehill.com

Medicare Advantage Grows; But Not Without Government Help

The net result, encouraging more plans to compete in the Medicare market, is not actually in the best interest of seniors. In a study published last month in Health Affairs, researchers found that too many choices with too little guidance can be overwhelming for Medicare enrollees, especially the growing proportion that is experiencing cognitive difficulties. “Our study suggests that the Medicare Advantage program presents an overabundance of choices for many elderly beneficiaries,” the researchers write. “Medicare Advantage plans currently compete for enrollees through the benefits they offer and the premiums they charge, but elderly beneficiaries with low cognitive function were not responsive to changes in these features.” The implication, according to Health Affairs, is that these “unresponsive” seniors may buy into plans not well suited to their needs, allowing private insurers to profit “by offering less-generous coverage or reducing benefits while still attracting or retaining enrollees with limited cognitive abilities.”
Source: healthbeatblog.com

Medicare Advantage Enrollment Grows by 10 Percent

Kaiser Family Foundation just released a Data Spotlight on 2012 Medicare Advantage Enrollment. The report shows that 2012 MA enrollment increased 10 percent from 2011 levels with the addition of 1 million new enrollees. The report also noted that MA enrollment has doubled since 2005. Given the payment cuts in the Medicare Modernization Act and Affordable Care Act, this market penetration is surprising. And MA is poised for even more growth in the next several years with the shift of retirees from employer drug coverage due to the loss of the Retiree Drug Subsidy tax benefits, state initiatives that are shifting dual eligibles into managed care, and the arrival of the baby boomers who are familiar with PPO products. It not unrealistic to imagine that MA plans could cover one-third of all Medicare beneficiaries. Some of the 2012 growth is probably due to the fact that premiums in all plans except Regional PPOs decined in 2012. This trend cannot continues since the ACA payment cuts are still being phased in and the quality demonstration providing higher bonuses will end after 2014. Plans are expected to increase premiums and reduce benefits beginning next year. As long as MA remains a better value than Medigap, we should expect to see enrollment continue to increase.
Source: gormanhealthgroup.com

How do I Quit Medicare Advantage?

The 5-star rating system is used by Medicare to monitor plans and ensure that they meet certain quality standards.  The ratings also make it easier for someone on Medicare to compare plans based on quality and customer service. “Low performer” icons are placed next to the names of plans that have received less than three stars for the past three years.  The star rating system considers 53 quality measures, such as success in providing preventive services, managing chronic illness, and keeping consumer complaints to a minimum.
Source: ehealthinsurance.com

Private Medicare Advantage plans being paid for phantom care of VA patients

Results: Among individuals who were eligible to enroll in the VA and in an MA plan, the number of persons dually enrolled increased from 485 651 in 2004 to 924 792 in 2009. In 2009, 8.3% of the MA population was enrolled in the VA and 5.0% of MA beneficiaries were VA users. The estimated VA health care costs for MA enrollees totaled $13.0 billion over 6 years, increasing from $1.3 billion in 2004 to $3.2 billion in 2009. Among dual enrollees, 10% exclusively used the VA for outpatient and acute inpatient services, 35% exclusively used the MA plan, 50% used both the VA and MA, and 4% received no services during the calendar year. The VA financed 44% of all outpatient visits (n = 21 353 841), 15% of all acute medical and surgical admissions (n = 177 663), and 18% of all acute medical and surgical inpatient days (n = 1 106 284) for this dually enrolled population. In 2009, the VA billed private insurers $52.3 million to reimburse care provided to MA enrollees and collected $9.4 million (18% of the billed amount; 0.3% of the total cost of care).
Source: pnhp.org

Matm2011 Health: Are You Ready for Medicare Open Enrollment 2012/2013?

The first step is to re-assess your health care needs. Have a look at your current drug prescriptions and how often you currently see your health care providers. Did you get any notices from your plan provider about changes to your plan? Make a list with your current medical needs and all that has changed since you last enrolled in your Medicare plan. Even when you like to keep your current coverage, it may be time to make a change to your plan, because a similar plan may offer you even more benefits or lower costs. As the competition in the Medicare insurance sector among private insurers is heavy, plan benefits and premiums are constantly changing, which benefits the consumers. So compare your list to other available Medicare advantage plans in your area by thoroughly checking all benefits and costs. Make sure to not only compare the monthly premiums, but consider your total out of pocket expenses – including all deductibles, co-payments and coinsurance! You can start your research at the Medicare.gov website, or by contacting a licensed insurance broker who specializes in Medicare. If you decide to consult an Medicare specialist, best is to look for one who is independent from a specific health insurance company, so he or she can offer you the whole spectrum of available plans. Those consultants may also be more motivated to find a plan that works best for you, while an insurance agent may be pushing you in one of the two or three plans that he or she has for sale. While it’s usually a good idea to ask friends and family for their recommendations, remember that medical needs are very individual and a Medicare plan that is perfect for your friend may not fit your health care needs. To make the right decision, it is also necessary that you know the differences between Medicare Advantage Plans and Medicare Supplemental insurance. There is no ‘one-size-fits-all’. For some, for example those who don’t see the doctor so often, Medicare Advantage plans may work better, while for others, especially seniors in rural areas with a limited amount of health care providers, a Medicare Supplement plan with a wider choice of doctors might be better – even though it may cost a little more. This is where money can be saved: by evaluating all currently available plans and comparing them to your current medical needs. The variety of Medicare plans makes choice complex, but if you want to find the best Medicare plan for your individual needs for 2013, don’t hesitate to compare plan benefits and quotes during the 2013 Medicare Open Enrollment period. Finally you should also be aware of two changes to Medicare enrollment this year: 1- Medicare enrollment starts earlier and ends earlier. As of October 15, eligible recipients can begin joining a new Medicare plan or change from the one they’re currently in, but you can only enroll through December 7th this year. (Last year, the enrollment period ran from mid-November through the end of the year.) 2- There’s year-around enrollment for some. There is one major exception to this enrollment period: You can switch to a five-star Medicare plan (these are the highest rated plans) at any point this year beginning on December 8th and going through November 30, 2012. But don’t wait to enroll – not everyone will have access to a five-star plan.
Source: blogspot.com

MHA Press Room: Report looks at Medicare Advantage enrollment trends

Enrollment in private Medicare Advantage health plans grew by 10% in 2012 to a record 13 million people, or 27% of Medicare beneficiaries, according to a new analysis by the Kaiser Family Foundation. The average monthly premium for the plans this year is $35, $4 less than in 2011.
Source: typepad.com

Standard HCPCS codes benefits everyone

Posted by:  :  Category: Medicare

By prescribing standards across all the different service, people are less confused when exchanging medical information. There is a uniform understanding when institutions and doctors discuss among one another. Misunderstandings are minimized. Procedures and medications are easily defined through the use of standard codes. In addition, Medicare can provide standardized payment arrangements for the same procedures done within the same region. For instance, Medicare will pay the same amount for any flu shot coded as 90658, as long as the flu shots are done within the same area. It may vary in other states or regions.  These standard codes are the same codes used when claiming in Medicare and Medicaid. Statement processing for facilities processes your medical transactions and prints electronic patient statements with the codes alongside the description and charge amount. The codes are encoded into the healthcare statement processing system. They are checked against the codes in the databases for correctness and validity. Some electronic cross checking is also possible. For instance, codes that are applicable for pregnancy tests can be checked against the gender of the claimant. If the claimant is a male, then the claims should be rejected. Medical suppliers have other services, such as ambulance services which may be coded by hospitals as non-medical services. These types of codes are treated differently by Medicare and most insurance companies.
Source: statementsonline.org

Video: Guess That Code Episode 2

Medical Coding And Billing: HCPCS Codes

The acronym HCPCS originally stood for HCFA Common Procedure Coding System, as the Centers for Medicare and Medicaid (CMS) was previously (before 2001) known as the Health Care Financing Administration (HCFA). The Healthcare Common Procedure Coding System (HCPCS) was established in 1978 to provide a standardized coding system for describing the specific items and services provided in the delivery of health care. Such coding is necessary for Medicare, Medicaid, and other health insurance programs to ensure that insurance claims are processed in an orderly and consistent manner. Initially, use of the codes was voluntary, but with the implementation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) use of the HCPCS for transactions involving health care information became mandatory.
Source: blogspot.com

Is your Medical Billing Team Doing it Right???

But it seemed like something was not right, when more often than not Medicare refused to pay for many of these exams and patients were made to bear half of the burden most of the times (amounting to more than $100) and sometimes the whole amount (in excess of $200), in case they lacked secondary insurances (like TriCare4Life). The old timers who had handled this in the past via paper claims could not be reached and the medical billing team was under increasing pressure to find out what was amiss. It was then an outsourced medical billing vendor was consulted. They immediately went through the EHR software’s automatic code suggestion engine and found that the software erroneously suggested only CPT code 99397, when it was prompted for exam options. It goes without saying that the right code to bill for newly eligible Medicare patients is the HCPCS code G0402, which was not even an option in the EHR software. And the young medical billing team were too naive to see this.
Source: billingparadise.com

Coding Ahead: List of 2011 HCPCS codes

G0402 Initial preventive physical examination; face to face visits, services limited to new beneficiary during the first 12 months of Medicare enrollment G0389 Ultrasound, B-scan and /or real time with image documentation; for abdominal aortic aneurysm (AAA) ultrasound screening 80061 Lipid panel 82465 Cholesterol, serum or whole blood, total 83718 Lipoprotein, direct measurement; high density cholesterol (hdl cholesterol) 84478 Triglycerides 82947 Glucose; quantitative, blood (except reagent strip) 82950 Glucose; post glucose dose (includes glucose) 82951 Glucose; tolerance test (gtt), three specimens (includes glucose) 97802 Medical nutrition therapy; initial assessment and intervention, individual, face-to-face with the patient, each 15 minutes 97803 Medical nutrition therapy; re-assessment and intervention, individual, face-to-face with the patient, each 15 minutes 97804 Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes G0270 Medical nutrition therapy; reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition or treatment regimen (including additional hours needed for renal disease), individual, face to face with the patient, each 15 minutes G0271 Medical nutrition therapy, reassessment and subsequent intervention(s) following second referral in same year for change in diagnosis, medical condition, or treatment regimen (including additional hours needed for renal disease), group (2 or more individuals), each 30 minutes G0123 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, screening by cytotechnologist under physician supervision G0124 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, requiring interpretation by physician G0141 Screening cytopathology smears, cervical or vaginal, performed by automated system, with manual rescreening, requiring interpretation by physician G0143 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with manual screening and rescreening by cytotechnologist under physician supervision G0144 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system, under physician supervision G0145 Screening cytopathology, cervical or vaginal (any reporting system), collected in preservative fluid, automated thin layer preparation, with screening by automated system and manual rescreening under physician supervision G0147 Screening cytopathology smears, cervical or vaginal, performed by automated system under physician supervision G0148 Screening cytopathology smears, cervical or vaginal, performed by automated system with manual rescreening P3000 Screening papanicolaou smear, cervical or vaginal, up to three smears, by technician under physician supervision P3001 Screening papanicolaou smear, cervical or vaginal, up to three smears, requiring interpretation by physician Q0091 Screening papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory G0101 Cervical or vaginal cancer screening; pelvic and clinical breast examination 77052 Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images; screening mammography (list separately in addition to code for primary procedure) 77057 Screening mammography, bilateral (2-view film study of each breast) G0202 Screening mammography, producing direct digital image, bilateral, all views G0130 Single energy x-ray absorptiometry (sexa) bone density study, one or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) 77078 Computed tomography, bone mineral density study, 1 or more sites; axial skeleton (e.g., hips, pelvis, spine) 77079 Computed tomography, bone mineral density study, 1 or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) 77080 Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; axial skeleton (e.g., hips, pelvis, spine) 77081 Dual-energy x-ray absorptiometry (dxa), bone density study, 1 or more sites; appendicular skeleton (peripheral) (e.g., radius, wrist, heel) 77083 Radiographic absorptiometry (e.g., photodensitometry, radiogrammetry), 1 or more sites 76977 Ultrasound bone density measurement and interpretation, peripheral site(s), any method G0104 Colorectal cancer screening; flexible sigmoidoscopy G0105 Colorectal cancer screening; colonoscopy on individual at high risk G0121 Colorectal cancer screening; colonoscopy on individual not meeting criteria for high risk 82270 Blood, occult, by peroxidase activity (e.g., guaiac), qualitative; feces, consecutive G0328 Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous G0103 Prostate cancer screening; prostate specific antigen test (PSA) 90655 Influenza virus vaccine, split virus, preservative free, when administered to children 6-35 months of age, for intramuscular use 90656 Influenza virus vaccine, split virus, preservative free, when administered to individuals 3 years and older, for intramuscular use 90657 Influenza virus vaccine, split virus, when administered to children 6-35 months of age, for intramuscular use 90660 Influenza virus vaccine, live, for intranasal use 90662 Influenza virus vaccine, split virus, preservative free, enhanced immunogenicity via increased antigen content, for intramuscular use Q2035 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Afluria) Q2036 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Flulaval) Q2037 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use, (Fluvirin) Q2038 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (Fluzone) Q2039 Influenza virus vaccine, split virus, when administered to individuals 3 years of age and older, for intramuscular use (not otherwise specified) G0008 Administration of influenza virus vaccine G9141 Influenza A (H1N1) immunization administration (includes the physician counseling the patient/family) G9142 Influenza A (H1N1) Vaccine, any route of administration 90669 Pneumococcal conjugate vaccine, polyvalent, when administered to children younger than 5 years, for intramuscular use 90670 Pneumococcal conjugate vaccine, 13 valent, for intramuscular use 90732 Pneumococcal polysaccharide vaccine, 23-valent, adult or immunosuppressed patient dosage, when administered to individuals 2 years or older, for subcutaneous or intramuscular use G0009 Administration of pneumococcal vaccine 90740 Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (3 dose schedule), for intramuscular use 90743 Hepatitis B vaccine, adolescent (2 dose schedule), for intramuscular use 90744 Hepatitis B vaccine, pediatric/adolescent dosage (3 dose schedule), for intramuscular use 90746 Hepatitis B vaccine, adult dosage, for intramuscular use 90747 Hepatitis B vaccine, dialysis or immunosuppressed patient dosage (4 dose schedule), for intramuscular use G0010 Administration of hepatitis B vaccine G0432 Infectious agent antigen detection by enzyme immunoassay (EIA) technique, qualitative or semi-qualitative, multiple-step method, HIV-1 or HIV-2, screening G0433 Infectious agent antigen detection by enzyme-linked immunosorbent assay (ELISA) technique, antibody, HIV-1 or HIV-2, screening G0435 Infectious agent antigen detection by rapid antibody test of oral mucosa transudate, HIV-1 or HIV-2 , screening G0436 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intermediate, greater than 3 minutes, up to 10 minutes. G0437 Smoking and tobacco cessation counseling visit for the asymptomatic patient; intensive, greater than 10 minutes. G0438 Annual wellness visit, including PPPS, first visit G0439 Annual wellness visit, including PPPS, subsequent visit
Source: codingahead.com

HCPCS Codes Announced for MediPlus™ Ag Silver Foam Wound Dressings

Available in three configurations—Foam Ag, Super Foam Ag and Comfort Foam Border Ag—MediPlus silver foam dressings meet the antibacterial control standards established by the FDA and provide an effective barrier to bacterial penetration. MediPlus silver dressings are indicated for use on a wide range of chronic and traumatic wounds that include ulcers (arterial, diabetic and venous), pressure sores, donor sites, surgical incisions/excisions and first- and second-degree burns.
Source: medipurpose.com

Introduction to HCPCS Level I Coding

The NCCI also employs Medically Exclusive Code Pairs (MECs) which identify codes that cannot reasonably be reported together. The NCCI Coding Policy Manual that is published annually by CMS describes why the NCCI considers how some codes cannot be logically reported on the same healthcare claim. Most of these mirror the instructions contained in CPT, but because CMS deals with HCPCS codes rather than CPT codes, the rationale is not universal. Commercial health insurance policies may consider some pairs of codes acceptable for reimbursement, while the NCCI does not. Professional medical billers need to be able to recognize that while all CPT codes are HCPCS codes, not all CPT codes are used the same way when they are HCPCS codes. CPT is designed to report what actually occurred for statistical purposes. HCPCS is designed to report services as succinctly as possible for reimbursement.
Source: medicalbillingandcodingu.org

Confusion reigns with new codes for therapeutic contact lenses

Each year several artists of Italian-American heritage come together to hold an art exhibition at Casa Italia in Stone Park, Il. These artists include internationally known individuals to those just starting to make a name for themselves within the artistic community. This video features the works of many of these artists as well as the exhibition recently h […]
Source: newsfromaoa.org

New HCPCS codes worth noting : Getting Paid

G9156: Evaluation for wheelchair requiring face-to-face visit with physician – notable because this code is used to report services related to a CMS action to correct improper payments for power mobility devices. Medicare contractors in the following states, CA, FL, IL, MI, NY, NC, and TX, began 100 percent prepayment review for initial rental or purchase claims after Jan. 1, 2012 and prior authorization of power mobility devices beginning April 1, 2012. This may be implemented in other states in the future. To compensate physicians for time associated with preparing and submitting a prior authorization request, code G9156 is reported after submission of the initial prior authorization request with the prior authorization tracking number provided by the Medicare durable medical equipment contractor. Claims are submitted to the Medicare Part B contractor and only one claim with code G9156 may be billed per beneficiary per power mobility device even if a physician must resubmit the request for prior authorization. For more information from CMS, see this presentation.
Source: aafp.org

Cigna Medicare Supplement Insurance

Posted by:  :  Category: Medicare

There are three main types of prescription drug pans, The Cigna Rx value plan, The Cigna Rx plus plan and the Cigna Rx complete plan. Monthly fees will vary and can run from as low as 17$ per month to as much as $53 per month for the most comprehensive coverage. All three plans use the same formulary of covered patient drugs. The Value Plan does require a deductible be paid for prescription claims, but the two higher priced policies offer no deductible processing.
Source: medicaresupplementinsurances.com

Video: YouTube Videos matching query: cigna medicare supplement

Cigna To Increase Supplemental Health Insurance Offerings With Acquisition

Fox News/Dow Jones: Cigna To Buy Great American Supplemental Benefits For $295 Million Cigna Corp. (CI) has agreed to acquire American Financial Group Inc.’s (AFG) Medicare supplement and critical-illness businesses for approximately $295 million in cash, as the managed-care company looks to expand its presence in the individual and seniors markets. Cigna said its acquisition of Great American Supplemental Benefits Group, one of the largest manufacturers of supplemental health insurance products in the U.S., is expected to close in the second half of 2012. Great American generated approximately $325 million of revenue last year (5/10).
Source: kaiserhealthnews.org

American Financial Group’s CEO Discusses Q2 2012 Results

Well, I think what you’re hearing is, we have again, we have court share reinsurance and we also have stop loss coverage. Think of it as buying cap coverage on your – similar to buying cap cover on your property exposures as (inaudible). I think what we’re saying is when you look at our programs that we’re projecting $0.50 under current conditions, which would reflect the latest net mill report I think which came out yesterday or I think it was either yesterday, or day before, also Monday’s USDA, so we’ve looked at that. Those are what we consider to be current conditions. And now we’ve also tried to stress test some of our big states to see where that would take us. And because of the quota share and our stop loss reinsurance, the answer is the same.
Source: seekingalpha.com

Medicare Provider Cigna Buys Medicare Carrier Health Spring

Health insurer Cigna Corp., the fifth-largest U.S. insurer, intends to buy HealthSpring Inc to boost its business selling Medicare plans as more and more Americans seniors become eligible. Medicare managed-care plans are among the fastest-growing products for health insurers as the baby-boom generation ages. The entry of the postwar baby boom generation into retirement is expected to further increase the demand for privately run Medicare Advantage plans, which currently account for 25 percent of Medicare enrollment.
Source: medicareadvantagesupplementplans.com

West Virginia Medicare Part D Plans

The following list details all 36 plans available to West Virginians and will allow you to compare premiums, deductibles, type of plan (basic or enhanced), whether or not there is extra coverage while in the Part D donut hole and Medicare Star ratings for each plan.
Source: partdplanfinder.com

CIGNA fills in its Medicare portfolio with Great American acquisition

Longer-term, the Great American acquisition builds out CIGNA’s specified diseases and other special coverages business (albeit nascent with $35M in revenue in 2011). These will fit well with consumer directed and account-based products and could play a great role on a private exchange or other defined contribution model. David Cordani did say in the most recent quarterly analyst call: “We do see some employers beginning to explore how they might move to the next generation of incentive alignment, which is a bit more of a defined contribution model.” Expect more acquisitions or alliances to build out a full defined contribution approach for commercial accounts (beyond retirement).
Source: reconstrategy.com

Earnings Preview: UnitedHealth Group Incorporated

On May 10, 2012, American Financial Group, Inc. announced that it reached a definitive agreement to sell its Medicare Supplement and Critical Illness businesses (headquartered in Austin, Texas and doing business as Great American Supplemental Benefits Group) to CIGNA Corporation for approximately $295 million in cash, subject to post-closing adjustments based upon statutory capital and surplus of transferred businesses as of the closing date.
Source: seekingalpha.com

American Financial to Keep Great American LTCI Unit

American Financial can reprice the policies to reflect adverse experience, subject to regulatory approval, but inability to get “price increases and appropriate investment yields on its closed block of long-term care policies may adversely affect [the company’s] profitability,” the company says in a 2011 financial statement filed with the SEC. “In addition, given the duration of the long-term care product, [the company] may be unable to purchase appropriate assets with cash flows and durations necessary to match those of future claims in that business.”
Source: lifehealthpro.com

Provides Medicare Supplement insurance safety net

About absolutely affordable Arkansas articles Australia business care Cash children Cigna current Dental eating emotional federal find Fitness from Georgia health healthy help Home information insurance Jobs Kaiser medical Medicare Mental need news nutrition Permanente plan principles private public Queensland Review Safety techniques Tips Travel
Source: threersnutrition.net

Here’s When To Apply For A Medicare Supplement

Posted by:  :  Category: Medicare

If you are denied coverage and your current Advantage plan is renewing for the following year, you will automatically be re-enrolled. If your plan is not renewing you will have a Special Enrollment Period available to enroll in another Advantage plan up to January 31st. This should give plenty of time for a decision from underwriting.
Source: seniorsupplementinsurance.com

Video: Patty and Richard say, “Apply online for Medicare” (20 seconds) – Social Security

How to Online Apply for Medicare

3. After clicking the link you will be redirected at social security website. And read tjheir online apply for Medicare eligibility. 4. In the steps; click on the “Apply For Medicare” button to start online applying process. 5. Before starting Medicare insurance process, you will need applying for benefit. If you are an already applicant for benefit, click on the “Continue Application”. Otherwise fill up the right side benefit application and click “Apply for benefit” 6. To continue medical insurance process click on the “Continue Application” button. In the next steps; enter your Social security number and others secure information to apply online. 7. Remember that, the online service are available Monday to Friday (5Am-1Am), Saturday (5am- 11 pm), Sunday (8am-10pm) and any holiday (5am- 11pm). 8. After completing Social security enrollment process, go to the Medicare website. And sign up in Medicare website to order use the service. 9. If you feel that it’s difficult please call at 1-800-772-1213 or visit your nearest office. To apply physically you will need birth certificate, driving license, and social security card and if you have any others proof insurance document.
Source: idealsuggestion.com

Major Improvements to Medicare Online Enrollment System

5010 AARP ABC Home Health Care Inc. accountable care organizations Agency for Health Care Administration Barack Obama Bill Nelson Bobby Lolley Centers for Medicare & Medicaid Services companionship services exemption Copays 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 George W. Bush 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 Medicaid Fraud Control Unit Medicare Fraud Strike Force MedPAC National Association for Home Care & Hospice 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

Home Health Care: Medicaid Eligibility Requirements

There are many benefits that go along with the Medicaid program. As long as you meet eligibility guidelines and requirements, you will have access to these benefits. It is executed state to state but the funding is made through reimbursements from the federal government. Currently, there are 25 categories of eligibility which can be classified into five coverage groups. These groups include children, individuals over the age of 65, individuals with disabilities and adults with dependent children. The eligibility will differ from state to state, but all states are required to cover mandatory groups. However, the state can decide whether to cover groups that are categorized as optionally eligible. Most states have forms online that you can download and print out, however no states currently allow you to submit an online application. These groups include pregnant women, children and low-income families who have dependent children. The income level of these groups must be lower than the poverty level. Some Medicare beneficiaries may also be eligible for additional coverage by Medicaid. These beneficiaries will vary from one state to another. Each state is allowed to use their own discretion to provide benefits to these groups. Always be sure to check the eligibility requirements for your state when planning an application. If you believe you have met the requirements and have been denied coverage, you have the right to appeal the decision. Any appeal information will be printed on your eligibility notice that will be received in the mail. To apply, you can obtain an application at an office run by your state government. You cannot yet apply for it online. If you fill out an application at an office, the office is responsible for processing the application. While the application process does take some time, most states are required to complete the application within 45 days. If the application is based on a disability, the state has up to 90 days. The most common reason for denial is an incomplete application, so make sure all parts of the forms are completed when filling out the application. Also be sure to have all required documentation available to include with the application. In some cases, if you are receiving Medicare, it may pay for some of the premiums, coinsurances and deductibles. You could also be eligible for Medicare related expense payment if your income is more than 100% or less than 120% of the poverty level. If you are disabled, it will pay for Medicare Part A premiums if you have lost your Medicare coverage due to employment. Your income must be below 200% of the poverty level. For state run programs to be eligible for funding there are certain services that must be provided to certain populations. The health care help must include services including hospital services, payment for physician services, nursing facilities for people over 21 years of age, surgical dental services, family planning, midwife services, x-rays, laboratory services, pediatric services, rural health clinic costs and federally-qualified health center services. An optionally eligible program will cover clinical services, prescription drugs, dental, prosthetics, optometry, nursing facilities and intermediate care for the mentally retarded. Each state will determine the duration of all its benefits. Federal guidelines must be followed and they require that the amount and duration of service is reasonable. Each state is responsible for placing a limit on benefits thereafter. In most cases, those on it are allowed to choose between health care providers. The state may also elect to run the program through an HMO. Always check with the state laws and guidelines for it to know what benefits are available. Payments are made directly to the health care providers. Providers are required to accept all its reimbursements in full. However, the state is allowed to change the copayments and deductibles for certain recipients. For emergency care and family planning services, the state cannot make these changes. Pregnant women, children under 18 and individuals in nursing homes are exempt from copayments. Currently, there is no limit or cap on the services received under it. The federal government is required to match what each state provides. The reimbursement rates must be sufficient so that providers will be attracted. This allows Medicaid benefits and services to be available to the qualifying population in the state.
Source: blogspot.com

Washington Medicare Supplement Enrollment Application for Plans …

In 1975, for estate planning purposes, the property was deeded to Harry Jack Stoffregen, … Neither Jonathan nor Nathan contributed to the cost of the improvements, upkeep, real estate taxes … by the defendants, have been abolished in Wisconsin. …. In Matter of Steele, the debtor took title to property as an agent or “straw …
Source: elzioo.com

top 10 medicare credentialing forms sources

Tagged with: billing • blog • codapedia • credentialing • directory • doctor • expertise • forms • helping • key • library • medical • medicare • medicare credentialing forms • medlicensecom • physician • physicians • pipl • points • solutions • understanding 
Source: renbud.net

How Can I Apply For Medicare Online?

Similar to applying for Medicare at a Social Security office or by telephone, the applicant must be close to the age for enrolling in the program, i.e., online applicants must be nearing their “full retirement age.” Full retirement age varies depending on the applicant’s date of birth. In addition, online applicants must not currently be a recipient of Medicare benefits, must reside in the United States or one of its territories or commonwealths, and must not be in need of Social Security benefits at the time of applying for Medicare.
Source: seniorcorps.org

Shared Savings Collaborative Launched by the Premier Healthcare Alliance to Help ACOs with Medicare Applications : e Yugoslavia

Premier, a provider-owned performance improvement alliance of 2,600 hospitals and 86,000 other care sites, created the collaborative to aid in the MSSP’s challenging application process.Developed in October 2011, the MSSP allows Medicare to enter into contracts with individual accountable care organizations (ACOs) that agree to take responsibility for the quality of care furnished to individual beneficiaries. In return, these ACOs, which often include hospitals, primary care physicians, specialists, medical groups and post-acute providers, have the opportunity to share in savings realized through improved care.
Source: eyugoslavia.com

Study: Nearly A Third Of Doctors Won’t See New Medicaid Patients

Posted by:  :  Category: Medicare

THE LITTLE MAN KILLED MEDICARE FOR EVERYBONE by SS&SSNew Jersey Medicaid officials acknowledge the lack of physician participation is a problem, but said the recent move to enroll nearly all Medicaid recipients into private managed care plans “should reverse the trend,” said Nicole Brossoie, spokeswoman for the New Jersey Department of Human Services which oversees Medicaid.
Source: kaiserhealthnews.org

Video: Canadian Wait List Insurance

IOM wants map redrawn on Medicare doctor pay

Changes in pay rates would shift between -5% and 5% for 96% of the counties across the country, according to the IOM report. Outside of that group, the highest reductions would be in Alaska, where rates would decrease by 18.8%, the committee said. Frontier states of Montana, Nevada, North Dakota, South Dakota and Wyoming also would see rates drop between 0.6% and 5.5%. Federal law mandates that physicians practicing in Alaska and the frontier states be paid at higher rates.
Source: nebraskaruralhealth.org

Which is better? Medicare or Medicare Advantage?

6. What is the Medicare Advantage plan’s star rating? The 5-star rating system is used by Medicare to monitor Medicare Advantage plans and determine if they meet certain quality standards.  The ratings also make it easier for someone on Medicare to compare plans based on quality and customer service. The star rating system considers 53 quality measures, such as success in providing preventive services, managing chronic illness, and keeping consumer complaints to a minimum. The higher the plan’s rating, the better. It’s not a bad idea to target plans that have a rating of 3.5 or higher.
Source: ehealthinsurance.com

How to save Medicare: Exclusive Q&A with Rep. Paul Ryan

Paul Ryan: There are 10,000 baby boomers retiring every day, with fewer workers paying into the program to support Medicare beneficiaries. This demographic transformation is taking place as health care costs increase at an unsustainable rate, directly threatening Medicare’s ability to deliver quality, affordable care to seniors. Non-partisan experts—from the Congressional Budget Office to Medicare’s own actuaries—warn of the looming bankruptcy of Medicare just as today’s seniors are in the heart of their retirement. Roughly one decade from now, the available funds to cover seniors’ hospital benefits will be fully exhausted. Absent reform, tens of trillions of dollars of empty promises will painfully become broken promises.
Source: humanevents.com

Does Low Income Mean More Medications?

1. Proper Food Choices: For a comprehensive guide on which foods to eat and which to avoid, see my nutrition plan. Generally speaking, you should focus your diet on whole, unprocessed foods (organic vegetables, grass-fed meats, raw dairy, nuts, and so forth) that come from healthy, sustainable, local sources, such as a small organic farm not far from your home. For the best nutrition and health benefits, you will want to eat a good portion of your food raw. Personally, I aim to eat about 75 percent of my food raw, including raw eggs and humanely raised pastured organic animal products that have not been raised on a CAFO (concentrated animal feeding operation). Nearly as important as knowing which foods to eat more of is knowing which foods to avoid, and topping the list is fructose. When consumed in excess, sugar acts as a toxin and drives multiple disease processes in your body, not the least of which is insulin resistance, a major cause of accelerated aging.
Source: setyoufreenews.com

One in Three Doctors Did Not Take New Medicaid Beneficiaries Last Year

For example, in largely rural states like Alaska and Wyoming, where Medicaid reimbursements are 50% higher than for Medicare, most physicians said they would accept Medicaid patients. In New Jersey, where Medicaid reimbursements are lowest, just 30% of physicians said they would accept new patients.
Source: californiahealthline.org

ARRA News Service: It’s Obama’s Plan that Guts Medicare

Phil Kerpen, Contributing Author: If Republicans ignored public opinion to gut Medicare to the tune of $741 billion over 10 years (and about $5 trillion over 20 years) there would be no other issue in any federal election until that law got repealed.  Democrats would be relentless and seniors would be up-in-arms.  And understandably so, especially because about 10,000 baby boomers are now retiring every day. Yet that was precisely what Obama’s health care law did to Medicare, and the liberal media is dutifully downplaying the significance of these devastating cuts.  Republicans should be banging the drum as heavily as the Democrats would if the shoe were on the other foot.  Yet there is a sense that it would be unseemly or inconsistent to do so.  We’re the party of cutting spending, right?  So we shouldn’t attack Obama’s slashing of Medicare?  Dead wrong. This was best explained by my friends Peter Ferrara and Larry Hunter, who wrote in the Wall Street Journal: The drastic reductions in Medicare reimbursements under ObamaCare will create havoc and chaos in health care for seniors. Many doctors, surgeons and specialists providing critical care to the elderly — such as surgery for hip and knee replacements, sophisticated diagnostics through MRIs and CT scans, and even treatment for cancer and heart disease — will cease serving Medicare patients. If the government is not going to pay, then seniors are not going to get the health services, treatment and care they expect.They continued: Everyone should know by now that Medicare suffers dramatic long-term deficits and unfunded liabilities, and is in need of fundamental, structural reforms. But effectively refusing to pay the doctors and hospitals that provide the medical care the program promises to seniors is no way to solve that problem.That is the crux of the issue.  The big lie from Democrats about Ryan’s plan is that it would end Medicare; quite the contrary, it would save Medicare from devastating cuts to reimbursement rates coming now thanks to Obama. Most conservatives would not have created the Medicare program the way it presently exists.  But it would be wrong to simply deny people who spent their entire working lives paying taxes into the Medicare system access to the care they believed they were paying for. Ryan’s plan recognizes resource constraints exist and empowers individuals to harness the power of competition to provide more with less and create greater choice.  It put seniors– not unaccountable bureaucrats like Obama’s IPAB — in control. Obama’s plan – now staring us in the face because his $741 billion in cuts (per the Congressional Budget Office:, see (page 5, table 2 of this PDF) have been enacted into law to pay for his vast new government takeover of health care – is to simply starve Medicare of funds. That’s wrong – and conservatives shouldn’t hesitate to attack it forcefully and without reservation. ————– © Copyright 2012 Phil Kerpen. He is the president of American Commitment where he first shared this article; a columnist on Fox News Opinion, and the author of Democracy Denied: How Obama is Bypassing Congress to Radically Transform America – and How to Stop Him. Phil Kerpen is a contributing author for the ARRA News Service.
Source: blogspot.com

Elecion focus back to where it should be!

Critics have called Ryan’s 2011 proposal the “end of Medicare as we know it,” and that’s true. Until now, Medicare has operated as a “fee-for-service” system; under Ryan’s plan, it would operate more like a voucher system, although Ryan and his aides have resisted this term. Medicare would cease to pay for health services directly, instead operating as a board that approves a menu of health plans for public sale and doles out predetermined lumps of money to people enrolled in Medicare, to help them buy those plans.
Source: wordpress.com

Metro Area Hospital To Be Hit with Federal Fines for ‘Frequent

“The complex issues that urban healthcare providers face, particularly here in New York City, clearly affect readmission rates and contribute to rates that are above national averages,” said Jim Mandler, a spokesman for Continuum Health Partners, which owns Beth Israel and St. Luke’s-Roosevelt. “At the Continuum hospitals, we have underway several initiatives … to enhance patient outcomes, create seamless transitions of care and expand access to primary care, with the ultimate goal of reducing unnecessary hospitalizations.”
Source: wnyc.org

Western Hero: Mediscare 2012

Paul Ryan is an excellent choice for VP. To steal from Hairy Reid and Palooka Joe Biden, Ryan is clean and articulate, light-skinned, and he speaks “with no Negro dialect, unless he wanted to have one.”  What more could we ask for? Romney made a serious choice and I commend him for now making this election a national referendum on our nation’s future. Do we continue down the progressive path of ruin, ending up as the Argentina of the north?  Or do we face facts and begin dismantling the creaking, fiscally-unsustainable statist model? From Paul Ryan’s speech: We won’t replace our founding principles…we will reapply them! We will honor you, our fellow citizens, by giving you the right and opportunity to make the choice: What kind of country do we want to have? What kind of people do we want to be? I thank Mitt Romney for putting the all-important questions front and center. Finally, American citizens will be forced to make a choice. Ryan’s Medicare Problem Trouble lurks, though. Paul Ryan could scare away older voters and moderates with his dangerous meddling with medicare. Here’s some analysis from the Medicare Chief Actuary:
Source: blogspot.com

ACP Internist: QD: News Every Day

Slightly more than two-thirds of physicians accept new Medicaid patients, reports a survey that establishes a baseline for whether better reimbursement provided under the Affordable Care Act might prompt more doctors to enroll recipients onto their patient panels. Nationally, 69.4% of physicians accepted new Medicaid patients, compared to self-pay (91.7%), Medicare (83.0%) or privately insured patients (81.7%), reported a study that appeared in the August issue of Health Affairs. While Medicaid reimbursement will equal Medicare reimbursement for the years 2013 and 2014, one internist spelled out why he’s not changing his practice management habits. Robert Maro Jr., MD, ACP Member, practices in Cherry Hill, NJ, the state with the lowest Medicaid acceptance rate among doctors (40.4%). He told Kaiser Health News why the Medicaid bump won’t change his mind about not accepting new patients: “Robert Maro Jr., a Cherry Hill internist, said he had not accepted new Medicaid patients for 15 years because of low pay. He said the state reimburses him only $23.50 for a basic office visit, less than half of what he gets from Medicare or private insurers. “Maro said he treats Medicaid patients in the hospital and in nursing homes, but would lose money treating them in the office, where his administrative costs are higher. “He said he would start seeing new Medicaid patients only if knew the pay hike under the health law would continue beyond 2014. Otherwise, he worries he would take on new patients only to see rates fall back to the old levels in 2015, and then he would be required legally and ethically to keep treating them.” An ACP survey tracks closely with the numbers reported in the Health Affairs study. In the survey, among 3,109 U.S. members (no students or associates) practicing entirely or primarily outpatient medicine who responded, 34.1% were no longer accepting Medicaid patients. Other items of note in the Health Affairs report: –Physicians in solo practice were 23.5 percentage points (34% relative difference) less likely to accept new Medicaid patients than physicians in offices with at least 10 other physicians; –Primary care physicians were 7.3 percentage points (11%) less likely to accept new Medicaid patients; –Physicians outside of Metropolitan Statistical Areas were 12.9 percentage points (19%) more likely than others to accept new Medicaid patients; –Physicians in the Midwest were 8.2 percentage points (12%) more likely than those in the Northeast to accept new Medicaid patients; and –Physicians practicing in counties where at least 15% of the population was under the federal poverty level were more likely by about 8.4 percentage points (12%) than others to accept new Medicaid patients.
Source: acpinternist.org

SHIIP provides Medicare assistance

Posted by:  :  Category: Medicare

'The election of Obama would, at a stroke, refresh our country's spirit' by Renegade98Of course there are other things to consider when determining Medicare options. SHIIP has created a handout meant to help navigate the Medicare system and initial enrollment process. The handout, “The Road to Medicare,” outlines the decisions people will need to make and what options are available through the Medicare system. To obtain a free copy of “The Road to Medicare,” call SHIIP at 1-800-443-9354 or visit SHIIP’s website at www.ncshiip. com.
Source: salisburypost.com

Video: The Tough Choices: Medicare – Inside E Street

Turning 65 means more choices for Medicare health plans boomers comparison of employer

If you are looking for a reference or register for Medicare, it is important to understand the options provided by the federal health program. This includes the alphabet of the Medicare Part a hospital, Part B-Medical, Medicare Advantage-Part C and Part D prescription-drug and Medigap. In most cases, whatever your choice, it is usually a good idea to enroll in Part A, as it is available free of charge. Registration in the other parts depend on several factors, including those described above. Consumers should also consider the options under each type.
Source: chircovskiidanceproject.com

Paul Ryan Wants to Destroy Social Security & Medicare

Lassie, what’s that? The US Government would put the savings and accounts of millions of Americans under the control of Wall Street banksters? The same criminals that bet against their own clients in derivative instruments they bet trillions on but never disclosed a blatant conflict of interest in and the bought-off DOJ and SEC okay? The same 2 and 20 fraudster current hedge fund tools that would laugh all the way to Davos as they would realize they literally get paid trillions more for doing nothing but earn fees for losing to the market indexes? The same Wall Street that commingles funds, steals individuals’ money, and escapes any justice despite literally 100s of 1,000s of documents, emails, etc. demonstrating guilt beyond a reasonable doubt mandating life sentences in Leavenworth? The same Wall Street that engages in price manipulation of LIBOR rates and basic commodities like oil, silver, gold, and aluminum (greetings Mr. Dimon and Blankfein, why do investment banks interest themselves in aluminum)? The same Wall Street that contributes to both D & R because real values don’t matter, only that you own regulators and law enforcement and policy makers thoroughly? The same Wall Street that cooks books to get Greece into the Euro and then wants austerity and to privatize public assets when countries have 20%+ unemployment? The same Wall Street that bribes public officials to construct economically untenable deals that bankrupt cities and counties (Jefferson County says what)?
Source: economicpopulist.org

Romney Hood and his Merry Band (Cartoon)

The only chance you have of your pet programs being saved is for whites to lose control of the political system. Voter ID and mass imprisonment of non-whites will be used to decimate the minority vote before that happens. White liberals have run out of ideas and the ability to energize their own young to stop the corporations from doing anything. Either you talk blacks and Latinos into doing it, or no one will do it at all.
Source: juancole.com

How Obamacare Reduces Our Liberty

Because these “Medicare funds” instead will have been spent on the new entitlements, the government will have to borrow additional funds to keep Medicare afloat. An estimated $136 billion of those savings will come in the form of cuts to Medicare Advantage plans, resulting in half the seniors who would have joined such plans by 2017 being forced back into the inefficient and fragmented fee-for-service Medicare system. Instead of giving seniors genuine choices that would reward plans that provide coordinated and effective care (and produce sizable savings to Medicare to boot), ACA has stacked the decks in favor of a badly outdated fee-for-service model that decades of research has shown costs more than it should even while producing worse outcomes.
Source: medibid.com

With Rep. Ryan pick, Medicare takes center stage in 2012 election

Conservative Republicans had reservations about some of  Romney’s past policy positions — especially his support for a law similar to Obama’s healthcare reform. But Ryan has the bona fides, and for a decade he’s been leading calls to cut the deficit and rein in entitlement programs.
Source: thehill.com

Choosing quality health care every step of the way

lets you compare up to 3 hospitals in your area to see how they did with different situations, such as giving their surgery patients an antibiotic at the right time to help prevent infection. It will also tell you about patient experience, such as the percentage of patients who reported “yes,” they would definitely recommend the hospital. Next, use our
Source: medicare.gov

2013 Medicare Drug Plan Premiums Will Be Similar To This Year — On Average

“Some folks won’t have access to plans at this price,” said Joe Baker, president of the Medicare Rights Center, a consumer advocacy group. “The bigger issue is that seniors have too much choice, or too much non-meaningful choice.” Seniors, he said, “tend to go for lower premiums, which look more affordable, but they can be surprised when their drug isn’t in the formulary.”
Source: kaiserhealthnews.org

Analysis: Ryan pick sets clear November choice

Republican presidential candidate, former Massachusetts Gov. Mitt Romney, left, listens as vice presidential running mate Rep. Paul Ryan, R-Wis., speaks at a rally at the Randolph Macon college, Saturday, Aug. 11, 2012 in Ashland, Va. (AP Photo/Mary Altaffer)
Source: washingtonexaminer.com

Booman Tribune ~ A Progressive Community

I watched the announcement that Paul Ryan will be Romney’s running mate, and parts of Ryan’s stupid speech. The whole thing was weird and foolish. Romney first told us that Paul Ryan is fond of lighting candles, and then announced that Ryan would be the next president of the United States. They chose some movie score to play for Ryan’s “dramatic” entrance, probably because almost no musicians will allow this conservative freak-show to use their music. Then Ryan delivered what can only be described as a lackluster speech filled with lies. His big applause line was that they are going to “make American great again.” What? You don’t think America is great now? F-U, buddy, move to Canada.
Source: boomantribune.com

America’s Most Popular States: The Reality of Living the Dream

Posted by:  :  Category: Medicare

It has flooding, mudslides, earthquakes, and wildfires. It’s short on cash and drinking water, but for the sixth year in a row, California still tops the list of states where people wish they lived. According to Harris Interactive, Inc., which conducted the poll, Florida, Hawaii, Texas, and Colorado round out the top five, making ample sunshine seem like a major selling point. But what’s the reality behind those sunny dreams of a new zip code? Here’s a closer look at what life is like in America’s most desired states.
Source: divinecaroline.com

Video: Big Country

Interesting point of view; The Democratic Party is more like a religious cult.

A discussion for debate and feedback. The Democratic Party, led by “Bhagwan Shree Rajneesh Obama,” is more like a religious cult than a political party, asserts talk-radio host Michael Savage. The president, said Savage, “is not really seen as a political figure as much as he is a religious figure.” Savage noted film director Spike Lee’s comment, in a CNN interview to be aired tomorrow, that Obama has been seen as “a savior, black Jesus.” Savage said Obama “is like a Jim Jones or a Baghwan Shree Rajneesh,” referring to the People’s Temple leader who led 909 people to their deaths in Guyana in 1978 and the East Indian guru who founded a town in Oregon in the 1980s that drew followers from all over the world. Savage pointed to Nancy Pelosi’s insistence that the spirits of suffragists Susan B. Anthony, Elizabeth Cady Stanton and Alice Paul spoke to her at the White House. Pelosi “sounds like a brainwashed member of a cult,” Savage said, noting she could become speaker of the House again. “This is the woman who was third in line for the presidency, who shoved Obamacare down our throats. The Democratic Party, Savage said, “is very much like a cult steeped in victimhood.” “It is like a cult that walks around with a chip on its shoulder saying, ‘We’re oppressed, and it’s those evil white males in the Republican Party who are keeping us back from our progress." Before you jump all over texan, I am just highlighting an opinon. Savage: ‘Bhagwan Shree Obama’ leading Democrat cult What say ye about this?
Source: browncafe.com

Masergy Executive Chairman Royce Holland to be Featured Speaker at COMPTEL PLUS Fall 2012 CEO Breakfast

Holland has served as Masergy’s executive chairman of the board of directors since February 2008 and a member of the board of directors since January 2005. In this role, he is responsible for strategic and operational direction, in addition to oversight of the company. Prior to becoming executive chairman of Masergy, Holland was CEO and director of McLeod USA, a competitive local exchange carrier that was sold to PAETEC in January 2008. Holland was also previously co-founder, chairman and CEO of Allegiance Telecom Inc., from 1997 until its 2004 acquisition by XO Communications Inc. Before founding Allegiance, he served as president and co-founder of MFS Communications Company Inc., one of the first competitive local carriers with operations in 52 metropolitan areas in North America, Europe and Asia.
Source: telecomreseller.com

Fly on the Wall: Checking Out Texas State Finances

I have enclosed a link so you can watch the 59 minutes hearing. If you are really interested in learning about the budget and our economy this is a MUST watch video. It is a bit slow at times, but hang in there and you will learn a lot. You will know more about the budget than anyone you know.  The first section focuses on our economy and the latter portion about the budget issues we will face next session.  You might want to watch the first thirty minutes, take a break, and then watch the second half. This will be a great video to show at a Tea Party meeting this fall.  It is the best one hour over-view of our total economic picture and finances in Texas that you can watch.
Source: ramparts360.com

Democratic Blog News: Mitt Romney Set To Pick Paul Ryan As Running Mate

In contrast to the conservative budget passed by House Republicans, the Congressional Progressive Caucus has proposed a budget that balances the budget in just ten years without cutting Social Security and Medicare. The Progressive plan repeals the Bush tax cuts for millionaires and billionaires, which saves three trillion dollars. Second, the plan cuts corporate taxpayer handouts to pharma, insurance and petrochemical industries and adds a new income tax bracket for billionaires. That raises at least an additional three trillion dollars. In the next decade the plan also cuts defense spending by about $1.8 trillion. The Progressive plan also lifts the Social Security payroll cap of $106,800 per year (2011) so that wealthy individuals who take home millions and billions of dollars in earnings every year can pay their fair percentage share of Social Security support, too. The Progressive plan not only protects and strengthens Social Security and Medicare for decades to come, it puts America back to work through infrastructure and high tech investments.
Source: blogspot.com

So Tasty, So Yummy: Texas (Maryland) Blue Crabs

Now that my parents are here in Houston, we can have crab feasts whenever we like. The day after the july 4th holiday, Miss F and I headed down to Clear Lake to enjoy some crabs. We had a call in to our favorite seafood market and knew the boat would be arriving around 11 am. We showed up at 11:15 am, just as they were dumping the crabs into the big storage vats. The crabs were massive. And fiesty. Unlike in Maryland, where they get the crabs for you, Texas is self serve. You get a pair of tongs and a paper bag. We collected about four dozen of the largest crabs in the bin and headed home. After making crabs for years in Maryland, I first had crabs steamed in Texas by my father-in-law. There are two things we learned from Texan crab steamers. First, they cook the crabs outdoors here, in a big crawfish/turkey fryer. We had to fashion a steamer out of a steamer basket, screws and nuts since it doesn’t come with a steamer. The second thing we learned from Texans was, once the crabs were steamed, to store them in big coolers to keep them piping hot. Add this information to our already vast Maryland crab steaming skills and you have the recipe for a perfect crab feast. A couple weeks later we headed to Maryland for my cousins wedding and went to Harris Crab House for crabs.  The verdict was we couldn’t tell the difference between the crabs from Galveston Bay and the crabs from the Cheasapeake Bay.  A little Old Bay, vinegar and a mallet…you have the makings for a perfect afternoon.
Source: blogspot.com