Electronic Billing & EDI Transactions

Posted by:  :  Category: Medicare

The information in this section is intended for the use of health care providers, clearinghouses and billing services that submit transactions to or receive transactions from Medicare fee-for-service contractors. EDI is the automated transfer of data in a specific format following specific data content rules between a health care provider and Medicare, or between Medicare and another health care plan. In some cases, that transfer may take place with the assistance of a clearinghouse or billing service that represents a provider of health care or another payer. EDI transactions are transferred via computer either to or from Medicare. Through use of EDI, both Medicare and health care providers can process transactions faster and at a lower cost. Please see pages on specific types of EDI conducted by Medicare for related links and downloads as applicable.
Source: cms.gov

Getting Paid: Billing Medicare for Diabetes Self

Copyright © 2001 by the American Academy of Family Physicians. This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. Contact fpmserv@aafp.org for copyright questions and/or permission requests.
Source: aafp.org

Medicare Billing: Wheelchairs, Scooters, Lift Chairs

We understand that the process of submitting claims to Medicare can be difficult and time consuming. To help make the process easier, SpinLife offers what is known as “courtesy billing”. This means that after you purchase an eligible product from SpinLife and request at checkout that we courtesy bill Medicare, we send you all of the documentation required by Medicare for you to complete with your physician. Once medically qualifying documentation is submitted into SpinLife, we can submit a claim to Medicare on your behalf. If your claim is approved by Medicare, they will reimburse you directly for their portion of your claim via mail.
Source: spinlife.com

Medical Billing Course Programs

LEVEL – MEDICAL BILLING FROM HOME  –  60 HOURS This is our most popular, comprehensive and most economical program Medical Billing Certification (CMBP).  Understanding HIPAA Certification Free Student Registration Chapters, Study Guides, Examinations for Chapters 1 – 9 Chapter AC1:  Understanding HIPAA, Exam & Separate Certification Chapter AC2:  Calculating Copays & Deductibles Practice Manager X3 Medical Billing Software Program Medical Billing Business Marketing Guide – Chapters 1-4 24/7 Online Student Support Board Telephone, Email & Live Chat Support Medical Billing Newsletter Medical Billing Course Certification CMBP Designation (Certified Medical Billing Professional) Register Now
Source: medicalbillingcourse.com

Medical Billing Certification

We are not a Diploma Mill/Education Clearinghouse.  You can’t come to us to learn Astrology, Plumbing, Day-Trading or Real Estate.  These “schools” are barely able to scratch the surface of what you need to learn about Medical Billing.  They also usually lump together “Medical Billing” with “Medical Coding.”  This is not only extremely impractical, it makes absolutely no sense whatsoever.
Source: medicalbillingcourse.com

ConnectiCare VIP Medicare Insurance

Posted by:  :  Category: Medicare

LIFESTYLE Do you want the option to seek medical services outside our network? Do you spend extended periods of time away from home? Consider our VIP Option (HMO-POS) Plans. These Plans offer the flexibility to receive care nationally from Medicare-approved doctors and hospitals. PRESCRIPTION DRUG COVERAGE Do you need coverage for your prescriptions? All Plans include Prescription Drug Coverage, except the VIP Prime 4 (HMO) Plan. If you have creditable Prescription Drug Coverage from a previous employer, or from the Veterans Administration (VA), our Prime 4 Plan may be a good option for you. ADDITIONAL SAVINGS Do you wear glasses or contacts? Our Vision Discount Program may be able to save you hundreds of dollars each year. Do you frequently fill prescriptions? Our Preferred Pharmacies and Home Delivery (Mail-Order) Pharmacy can offer both convenience and savings. DENTAL NEEDS Will you need dental care? Our optional Dental Plan offers you a great value. You’ll get both preventive and comprehensive services for an additional low monthly premium.
Source: connecticare.com

Compare Medicare Advantage & Supplemental Plans

Medicare supplement plans (or Medigap plans) offer benefits in addition to the benefits offered by traditional Medicare Parts A and B, and they are offered by private insurance companies. There are several different types of Medicare supplement plans available, including Plan A, Plan C, Plan F, Plan M and Plan N. Medicare supplement plans and Medicare Advantage plans are not complementary, so it is important to understand which type of policy makes the most sense for you. Our Medicare agents are standing by to walk you through a comparison of the costs and benefits of each type of plan, and to help you choose a Medicare supplement plan that best meets your needs.
Source: medicaresolutions.com

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

Medicare supplement plans (or Medigap plans) offer benefits in addition to the benefits offered by traditional Medicare Parts A and B, and they are offered by private insurance companies. There are several different types of Medicare supplement plans available, including Plan A, Plan C, Plan F, Plan M and Plan N. Medicare supplement plans and Medicare Advantage plans are not complementary, so it is important to understand which type of policy makes the most sense for you. Our Medicare agents are standing by to walk you through a comparison of the costs and benefits of each type of plan, and to help you choose a Medicare supplement plan that best meets your needs.
Source: medicaresolutions.com

Medicare Supplement Plans & Quotes

Turning 65 is stressful, and the amount of information people receive leading up to their birthday is astounding. From the stacks of mail piling up on your desk, to the seemingly endless phone calls and quotes from insurance companies and agents, the task of gathering honest, unbiased information can feel impossible. Our goal is to offer what nobody else will, which is why we provide medicare supplement quotes, financial ratings, benefit information, application fee data, price history, and pricing methodology for all supplemental insurance companies in one clean, concise report. Our free, no obligation service is designed to give you the information you need regarding Part D and Medicare Supplement Plans in order to make an educated purchasing decision. In addition, we offer continued support for all of our customers to ensure they have no claims or billing issues. On an annual basis we review all medicare supplement insurance quotes and plan options in an effort to notify our customers of any new or better plans that may be available.
Source: medicaresupplementshop.com

Your Medicare Supplemental Insurance Information – MedicareSupplemental.com

There are exceptions to the standardization if you live in certain states, such as Massachusetts, Minnesota, and Wisconsin. Depending on your state, you may be able to buy another type of Medigap policy called Medicare SELECT (a Medigap policy that requires you to use specific hospitals and in some cases specific doctors to get full benefits). Who Provides Medicare Supplemental Insurance? Medicare supplemental insurance is provided by private insurance companies such as AARP, BlueCross BlueShield, Globe Life, Humana, Mutual of Omaha, Transamerica Life, United American, UnitedHealthcare and many others. Remember from above that Medigap insurance companies can sell you only a “standardized” Medigap policy. All Medigap policies must have specific benefits so you can compare them easily on the basis of price.
Source: medicaresupplemental.com

Compare Medicare Supplement (Medigap) Plans and Rates in Your Area

"Times have changed since my mother had an AARP J plan and I was totally confused by the options available. Stan walked me through the process in a very educational, methodical, friendly way, and I feel secure now that we’re making the correct decision to provide the best possible coverage for my husband." – Pat K.
Source: medigap360.com

Medicare Supplement Insurance Quote Engine

In addition to Medicare supplement insurance, we are pleased to be participating in the Medicare Advantage market. The Medicare Advantage policy is a low cost alternative to a Medicare supplement policy and is especially advantageous for those less than 65 years old. The Private Fee For Service (PFFS) is a type of Advantage plan that allows Medicare recipient to visit any doctor, any hospital, anywhere. Therefore, many Medicare recipients are well served by the lower cost Private Fee For Service plan.
Source: bestmedicaresupplement.com

Medicare Supplemental Insurance

Finding the best Medicare Supplemental insurance, Medicare Advantage, and Medicare Part D has gotten more complicated nearly every year. In 2010 Medicare Supplement Insurance added 2 new plans Medigap plan N and Medigap Plan M. At the same time they eliminated several other Medicare Supplement options. Medicare Advantage insurance plans redefine benefits and premiums every year. And, with future Medicare subsidies uncertain due to changing regulation from healthcare reform who can keep up. For many individuals Medicare Supplement Insurance is becoming the best option. Unfortunately, comparing Medicare Supplemental Insurance Plan premiums (Medigap) and Medicare Advantage plans can be a time consuming endeavor. Our highly trained insurance advisors can explain all of your supplemental Insurance options, and assist in finding the best Medicare supplement and Medicare Part D combination that best fits your specific needs. With all the options affecting Supplement insurance and Part D it makes sense to have an expert assist you through the maze.
Source: mysenioradvisorsgroup.com

What’s Medicare Supplement Insurance (Medigap)?

Some Medigap policies also offer coverage for services that Original Medicare doesn’t cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.
Source: medicare.gov

Affordable Health Insurance in Ohio

Posted by:  :  Category: Medicare

If you enrolled in a plan through the Health Insurance Marketplace for 2014, you should have received an important tax statement in the mail, called Form 1095-A. Read more about this form, including information regarding what to do if the form you received is incorrect.
Source: summacare.com

SummaCare Notice of Sanction 8

The page could not be loaded. The CMS.gov Web site currently does not fully support browsers with “JavaScript” disabled. Please enable “JavaScript” and revisit this page or proceed with browsing CMS.gov with “JavaScript” disabled. Instructions for enabling “JavaScript” can be found here. Please note that if you choose to continue without enabling “JavaScript” certain functionalities on this website may not be available.
Source: cms.gov

UnitedHealthcare Community Plan

Posted by:  :  Category: Medicare

AmeriChoice is the premier provider in the United States of high quality, personalized public sector health care programs, serving more than three million people in Medicaid, Medicare and Children’s Health Insurance Programs in 25 states and the District of Columbia. AmeriChoice is a business of UnitedHealth Group (NYSE: UNH), a diversified Fortune 50 health and well-being company. AmeriChoice has invested in the systems and people to successfully provide quality service to our state customers and we have designed health plans that meet the unique needs of the diverse populations we serve. The unique AmeriChoice Personal Care Model™ features direct member contact by clinical staff who work to build a support network for chronically and acutely ill members involving family, physicians and government and community-based organizations. The goal is to employ practical solutions to improve members’ health and keep them in their communities, with the resources they need to maintain the highest possible functional status. AmeriChoice uses a variety of advanced technology applications to ensure that high quality, timely and appropriate health care is available to all members. We have developed our own software to monitor member access to services. We use a sophisticated clinical risk stratification tool to ensure that our members are receiving optimal care. We emphasize preventive health and education. We regularly encourage members to get annual physicals and routine diagnostic and screening tests, and we often work with community organizations to ensure that there are no cultural or language barriers to our members getting the care they need. AmeriChoice believes that compassion and respect are essential components of a successful health care company. We contract with community-based networks and employ a diverse workforce, with varied backgrounds and extensive practical experience that gives us a better understanding of our members and their needs. Our detailed knowledge of our members and our service areas, the application of cutting-edge technology and the commitment of our employees have made AmeriChoice the leading choice for quality public sector health care.
Source: americhoice.com

Health Insurance Plans for Individuals, Employers, Medicare

Insurance products and services offered are underwritten by All Savers Insurance Company, Health Plan of Nevada, Inc., UnitedHealthcare Community Plan, Inc., UnitedHealthcare Insurance Company, UnitedHealthcare of Alabama, Inc., UnitedHealthcare of Florida, Inc., UnitedHealthcare of Louisiana, Inc., UnitedHealthcare of the Mid-Atlantic, Inc., UnitedHealthcare of the Midwest, UnitedHealthcare of Mississippi, Inc., UnitedHealthcare of New England, Inc., UnitedHealthcare of New York, Inc., UnitedHealthcare of North Carolina, Inc., UnitedHealthcare of Ohio, Inc., UnitedHealthcare of Pennsylvania, Inc., Oxford Health Plans (NJ), Inc.
Source: uhc.com

Medicare Supplement Plan G

Posted by:  :  Category: Medicare

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbsil.com

Medicare.gov: the official U.S. government site for Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Medicare Supplement Plan G

The majority of Medicare Supplement plans do not cover Part B excess charges, which is why Plan G may be of interest for those with frequent medical needs. Excess charges are additional expenses incurred outside of the Medicare-approved charge. For example, if Medicare’s allowed charge for a doctor’s appointment is $100, the physician may choose not to accept that amount, electing instead to charge an additional 15% for the appointment. In this instance, Medicare would pay 80% of the allowed charge, sending the physician $80. The beneficiary would then be responsible for paying not only the remaining $20, but also the excess 15% charge, another $15, making the total out-of-pocket cost $35. Because Plan G covers the Part B excess charges, all of the out-of-pocket costs in this example are covered by this policy.
Source: ehealthinsurance.com

Medicare Supplement Plan G

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row. ** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy’s “Core Benefits.” During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
Source: bcbstx.com

Medicare Plans & Coverage: Part A, Part B, Part C, Part D

Medicare is a federal insurance program that covers hospitalization expenses as well as doctor and medical expenses. To be eligible for Medicare, one must be an American citizen 65 years or older, or younger with a qualifying disability.
Source: medicareconsumerguide.com

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Extra Help with Medicare Prescription Drug Plan Costs

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Source: socialsecurity.gov

Medicare Provider Utilization and Payment Data

As part of the Obama administration’s work to make our health care system more affordable and accountable, data are being released that summarize the utilization and payments for procedures and services provided to Medicare fee-for service beneficiaries by specific inpatient and outpatient hospitals, physicians, and other suppliers. These data include information for the 100 most common inpatient services, 30 common outpatient services, and all physician and other supplier procedures and services performed on 11 or more Medicare beneficiaries. Providers determine what they will charge for items,services, and procedures provided to patients and these charges are the amount the providers bill for an item, service, or procedure.
Source: cms.gov

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

Medicare supplement plans (or Medigap plans) offer benefits in addition to the benefits offered by traditional Medicare Parts A and B, and they are offered by private insurance companies. There are several different types of Medicare supplement plans available, including Plan A, Plan C, Plan F, Plan M and Plan N. Medicare supplement plans and Medicare Advantage plans are not complementary, so it is important to understand which type of policy makes the most sense for you. Our Medicare agents are standing by to walk you through a comparison of the costs and benefits of each type of plan, and to help you choose a Medicare supplement plan that best meets your needs.
Source: medicaresolutions.com

Medicare Advantage, Medicare Advantage Plans

Aetna Medicare is an HMO/PPO/PDP plan with a Medicare contract. Enrollment in Aetna Medicare depends on contract renewal. The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, provider network, premium and/or copayments/coinsurance may change on January 1 of each year.
Source: aetnamedicare.com

Medicare Advantage Fact Sheet

Since 2006, Medicare has paid plans under a bidding process.  Plans submit “bids” based on estimated costs per enrollee for services covered under Medicare Parts A and B; all bids that meet the necessary requirements are accepted.  The bids are compared to benchmark amounts that are set by a formula established in statute and vary by county (or region in the case of regional PPOs).  The benchmarks are the maximum amount Medicare will pay a plan in a given area. If a plan’s bid is higher than the benchmark, enrollees pay the difference between the benchmark and the bid in the form of a monthly premium, in addition to the Medicare Part B premium.  If the bid is lower than the benchmark, the plan and Medicare split the difference between the bid and the benchmark; the plan’s share is known as a “rebate,” which must be used to provide supplemental benefits to enrollees.  Medicare payments to plans are then adjusted based on enrollees’ risk profiles.
Source: kff.org

Medicare Supplemental, Advantage, and Part D Plans

Because of the significant amount of out-of-pocket payments required by traditional Medicare, a booming market of private-sector insurance products has grown up around the government programs. These Medicare-related insurance products are one of the fastest-growing segments of the U.S. health insurance industry overall. And they are the part of the market on which a smart consumer should focus his or her attention. Medicare Providers mission is to help seniors understand these products and provide tools assist in the decision making process.
Source: medicare-providers.net

Medicare.gov: the official U.S. government site for Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Michigan Medicare Health Insurance Plans

Medicare is a health insurance program run by the government for people age 65 and older, and for people under 65 with certain disabilities. Understanding more about Medicare will make it easier to choose the right plan. Our Medicare 101 section has resources to help you do that.
Source: bcbsm.com

Medicare.gov: the official U.S. government site for Medicare

Posted by:  :  Category: Medicare

The page could not be loaded. The Medicare.gov Home page currently does not fully support browsers with "JavaScript" disabled. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available.
Source: medicare.gov

Extra Help with Medicare Prescription Drug Plan Costs

Medicare beneficiaries can qualify for Extra Help with their Medicare prescription drug plan costs. The Extra Help is estimated to be worth about $4,000 per year. To qualify for the Extra Help, a person must be receiving Medicare, have limited resources and income, and reside in one of the 50 States or the District of Columbia.
Source: socialsecurity.gov

Cost Report Data provides hospital financial information from Medicare cost reports filed by hospitals and contained in the CMS HCRIS file

CostReportData.com provides online Medicare cost report data to healthcare financial and reimbursement professionals. Our database of more than 6,000 hospitals is built from Medicare cost report information obtained from the federal Centers for Medicare and Medicaid Services (CMS). Information is presented in familiar worksheet formats that can be viewed online, printed, and downloaded in Excel or pdf formats. Pricing is economical … whether you need data on a just few hospitals or unlimited access throughout the year. Use the site for free to look up a hospital and see the periods and worksheets available.  Click on Single Cost Reports to test drive and see how easy it is to have all cost reports since FY 1996 at your fingertips.
Source: costreportdata.com