DMEPOS Competitive Bidding

Posted by:  :  Category: Medicare

Under the program, a competition among suppliers who operate in a particular competitive bidding area is conducted. Suppliers are required to submit a bid for selected products. Not all products or items are subject to competitive bidding. Bids are submitted electronically through a web-based application process and required documents are mailed. Bids are evaluated based on the supplier’s eligibility, its financial stability and the bid price. Contracts are awarded to the Medicare suppliers who offer the best price and meet applicable quality and financial standards. Contract suppliers must agree to accept assignment on all claims for bid items and will be paid the bid price amount. The amount is derived from the median of all winning bids for an item.
Source: cms.gov

Competitive Bidding Program

The Competitive Bidding Program replaces the outdated prices Medicare has been paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it pays for those equipment and supplies under the Competitive Bidding Program. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers.
Source: medicare.gov

Medicare Expands Competitive Bidding Program for Durable Medical Equip…

You can also get the supplies from a store or pharmacy that accepts "Medicare assignment." This means that the store will accept the Medicare-approved amount as payment in full and that you cannot be charged more than a 20 percent copay (after you meet your annual deductible). A Medicare contract supplier can’t charge you more than that for the equipment or supplies included in the competitive bidding program.
Source: aarp.org

DME Competitive Bidding Program

The Competitive Bidding Program replaces the outdated prices Medicare has been paying with lower, more accurate prices. Under this program, suppliers submit bids to provide certain medical equipment and supplies at a lower price than what Medicare now pays for these items. Medicare uses these bids to set the amount it will pay for those equipment and supplies under the competitive bidding program. Qualified, accredited suppliers with winning bids are chosen as Medicare-contract suppliers.
Source: medicare.gov

Health Financial Systems Medicare Cost Report Software (MCR)

Posted by:  :  Category: Medicare

History: Since 1981, Health Financial Systems (HFS) has been developing and marketing CMS approved Medicare cost reporting software to assist health care facilities meet their governmental reporting requirements. HFS Medicare Cost Report software is used to prepare more cost reports than any other cost report system, making HFS the largest automated cost report vendor in the United States. [more…]
Source: hfssoft.com

Medicare & Medicaid Cost Report l Owner Administrator Forum Seminar

Medicare Training & Consulting, Inc., was founded by Jim Plonsey in the Chicago area. After training Medicare auditors for Blue Cross Association, Jim established a business training Medicare auditors. This lead to doing cost reimbursement seminars for providers, most notably, home health agencies. Medicare Training & Consulting, Inc. has become a leader in providing Owners and Administrators with the reimbursement strategies.
Source: medicareconsulting.net

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).
Source: costreportdata.com

2016 Medicare Cost Report Training

With more than ten years of experience in the healthcare industry, Jason focuses primarily in the regulatory environment, assisting clients with Medicare and Medicaid reimbursement services and other related consulting projects. His healthcare background has allowed him to work with a variety of healthcare entities from large urban hospital systems to small rural facilities. His healthcare experience includes handling Medicare and Medicaid Cost Reporting, Wage Index Analysis, Occupational Mix Surveys, DSH, Bad Debts, Medical Education and Third Party Accounting.
Source: dhgllp.com

Medicare Cost Savings Programs

The SLMB program provides payment of Medicare Part B premiums only for individuals who would be eligible for the QMB program except for excess income. Income for this program must be more than 100% of the FPL, but not exceed 120% or 135% of the FPL.
Source: mo.gov

The Rising Cost of Living Longer: Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare

Consistent with other studies documenting higher costs for patients at the end of life, this analysis shows that Medicare per capita spending was nearly 4-times greater among beneficiaries who died in 2011, on average, than among those who lived the entire year.  Yet the analysis also shows that Medicare per capita spending among decedents declines with age, suggesting that patients, families, and providers may be opting for less intensive and less costly end-of-life interventions for beneficiaries as they grow older.  This possibility is consistent with the finding that average per capita spending on hospice services among beneficiaries in traditional Medicare increases with age, due to both a larger share of beneficiaries electing hospice at older ages and higher per capita hospice costs for older than younger Medicare beneficiaries who elect hospice care.
Source: kff.org

New Report on the “Rising Cost of Living Longer” Details Medicare Spending by Age

These key findings are also discussed in a companion article published as a web first today in the journal Health Affairs titled, Medicare Per Capita Spending By Age and Service: New Data Highlights Oldest Beneficiaries. The analysis is based on 2000-2011 Medicare claims data from the Centers for Medicare and Medicaid Services’ Chronic Conditions Data Warehouse. The study examines spending among beneficiaries in traditional Medicare because comparable spending data are not available for beneficiaries enrolled in Medicare Advantage.  The spending figures in the analysis do not include personal or Medicaid-related spending on long-term care.
Source: kff.org

Highmark: Your Health Care Partner

Posted by:  :  Category: Medicare

Highmark Inc. is a national, diversified health care partner serving members through its businesses in health insurance, dental insurance, vision care and reinsurance. Our mission is to make high-quality health care readily available, easily understandable and truly affordable in the communities we serve.
Source: highmark.com

Highmark Medicare Services is now Novitas Solutions

Physicians and medical billing companies should not face many disruptions as a result of this transition. According to Novitas Solutions, the current Highmark Medicare website will be fully transitioned to the new Novitas site by March 30, 2012. During the transition, visitors to the old website (https://www.highmarkmedicareservices.com) will be automatically re-directed to the new Novitas Solutions website (https://www.novitas-solutions.com), where a new header and page logo can be seen. Bookmarks that users may already have for the Highmark website will purportedly still work with the new page. The Electronic Payer ID has not appeared to change, so claims submission and processing should remain unaffected by the transition. For more information, see the Informational Alert here: https://www.novitas-solutions.com/partb/info-alerts.html.
Source: healthcarebiller.com

Highmark Direct :: Medicare Information

A Medicare Supplement policy is different from a Medicare Advantage Plan.  MA plans offer ways to get Medicare benefits, while a Medicare Supplement policy only supplements your Original Medicare benefits.  You can purchase a Medicare Supplement insurance plan from a private company to help pay for costs and services that your Original Medicare doesn’t cover.  In addition to helping offset Original Medicare’s high cost-sharing (copayment, coinsurance and deductible costs). Medicare Supplement policies may cover other services such as medical care during travel outside of the U.S.
Source: highmarkdirect.com

Highmark Medicare Services Inc Becomes Novitas Solutions Inc

Effective March 10, Novitas Solutions will begin to migrate the current HMS Web site to the new Novitas Solutions Web site, www.novitas-solutions.com. Novitas is targeting completing the name change to all active Web page content by March 30. Although main headers throughout the Web site will be changed, some historical documents, such as Medicare reports issued under HMS, will not be changed to reflect the new name.
Source: apta.org

Health Insurance, Dental Insurance & Other Insurance Plans

Posted by:  :  Category: Medicare

Saving money on health care can be a challenge. But we’re here to help. There are a number of ways to reduce your out-of-pocket costs. For example, choose an in-network doctor or hospital instead of one that’s out of network. Another good way to save is to choose a plan that is compatible with a tax-advantaged health savings account.
Source: aetna.com

Health Insurance Quotes & Plans

If you’d like to speak with us about your insurance coverage options, we have more than 10,000 licensed insurance benefits advisors across the nation. It’s our job to ensure you find the right plan for your needs.
Source: gohealthinsurance.com

How Medicare Advantage Plans work

Posted by:  :  Category: Medicare

Medicare Advantage Plans, sometimes called “Part C” or “MA Plans,” are offered by private companies approved by Medicare. If you join a Medicare Advantage Plan, you still have Medicare. You’ll get your Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) coverage from the Medicare Advantage Plan and not Original Medicare.
Source: medicare.gov

Medigap vs. Medicare Advantage Plan

Medicare Advantage comprises a variety of private health plans — most often HMOs and PPOs — that Medicare offers as a coverage alternative to the traditional program. Every plan must cover all the same benefits that traditional Medicare covers. But the plans can charge different copayments (often lower than the traditional program but not always) and offer extra benefits. Most charge a monthly premium in addition to the Part B premium, but some don’t. Most include prescription drug coverage at no additional cost. Some cover routine hearing and vision services, usually as a separate package for an additional premium. All plans, by law, have annual limits on out-of-pocket costs. Another difference from the traditional program is that most plans require you to go to doctors and other providers within their service network or pay higher copays for going out of network.
Source: aarp.org

Medicare Advantage: Private Health Insurance Through Medicare

Medicare Advantage plans may give you some discounts or pay for services that Original Medicare may not cover. However, Medicare Advantage plans are administered by private health insurers and you’ll be required to follow your plan’s rules. Original Medicare allows you to see just about any doctor and go to any hospital that accepts Medicare , which most providers accept. With Medicare Advantage plans, you’re typically restricted to the doctors and hospitals included in the plan’s network. You might need referrals to see a specialist.
Source: webmd.com

What is Medicare Advantage?

Medicare Advantage offers a lot of benefits at a low-cost. These plans are inexpensive, basic plans, that can limit your out of pocket costs, as long as you read the fine print, are okay with copays that can add up and a limited network, this might be the right fit. If you have further questions call the number above or contact Senior65.
Source: senior65.com

What is Medicare Advantage?

Medicare Part C (also known as Medicare Advantage plans) is an alternative to Original Medicare and is offered by private companies. These plans combine Medicare Part A and Medicare Part B and often include prescription drug coverage (Medicare Part D).
Source: aarp.org

Welcome to Your Texas Benefits

Posted by:  :  Category: Medicare

You can fill out this screening form to find out which benefits and support services you might be able to get. At the end of the form, you can decide if you want to log in and: (1) apply for benefits, and (2) send your form to support programs and ask them to contact you about their services.
Source: yourtexasbenefits.com

HHSC, TWH, Part A, Determining Eligibility, Section 800, Medicaid Eligibility

A child is continuously eligible for six months. If a household fails to report required information at application that causes a child to be ineligible for Medicaid, deny the EDG and send a fraud referral to the Office of Inspector General. This does not apply if the household provides verification required by policy. For example, the household applies for Medicaid for a child, provides one pay stub, and is determined eligible. If providing more income verification would result in the child being ineligible, do not deny the Medicaid EDG. The child remains continuously eligible for the six-month period, because policy requires only one pay stub to verify income for a child’s Medicaid EDG. Address the income discrepancy at redetermination.
Source: tx.us

Health and Human Services Commission

HHSC is seeking candidates for the Texas Medicaid Electronic Health Record (EHR) Incentive Program Ad Hoc Review panel. Ideal candidates would be familiar with EHR systems and the EHR Incentive Program. Responsibilities include reviewing materials related to the processes regarding Medicaid EHR incentive payments. Panel members will participate in discussions and provide recommendations to HHSC regarding the materials reviewed. Work is estimated to take up to 5 hours a month and meetings will be conducted by web or phone. All positions are voluntary. The term for serving on the panel is one year. Interested candidates should complete and submit an application.
Source: tx.us

Health Insurance, Dental Insurance & Other Insurance Plans

Posted by:  :  Category: Medicare

Saving money on health care can be a challenge. But we’re here to help. There are a number of ways to reduce your out-of-pocket costs. For example, choose an in-network doctor or hospital instead of one that’s out of network. Another good way to save is to choose a plan that is compatible with a tax-advantaged health savings account.
Source: aetna.com

Health Insurance – State Farm®

El siguiente contenido aún no está disponible en español. Nuestras disculpas por cualquier inconveniencia que esto pueda causar. Este contenido estará disponible en español en un futuro cercano.
Source: statefarm.com

Health Insurance Quotes, Medical Insurance, Affordable Health Insurance Plans

Brands You Know and Trust HealthPlanOne works with all major carriers. We are an Aetna “Premium Producer”, an Anthem “Premier Partner”, and a Humana “Strategic Alliance Partner”. We also work with Celtic, Cigna, Oxford, Unicare, Unitedhealthcare Life Insurance Company and Golden Rule Insurance Company and dozens of other health insurance companies.
Source: healthplanone.com

Definition of Premiums in Health Insurance

Posted by:  :  Category: Medicare

A premium is the monthly fee that is paid to an insurance company or health plan to provide health coverage, including paying for health-related services such as doctor visits, hospitalizations, and medications.
Source: about.com

Health Insurance Premiums Medical Insurance Health Insurance Quotes

As an employee this doesn’t necessarily have to be bad news for you.  The individual market has been coming on strong in the last couple of years.  Some predictions are saying that by the time health care reform kicks in 2014 some 78 million people will be dropped from their employer insurance and move, by necessity,  to the individual market.  Carriers like BlueShield/BlueCross of Florida have introduced health plans that have a $250.00 individual deductible.  If that deductible is ever met, the plan pays 90% and the insured pays 10% with a maximum-out-of-pocket of $2500.00. It is a PPO plan with doctor visits,  $0 co-pays for well-care visits, free labs, prescription coverage with a $10.00 co-pay for generics and a flat $150.00 fee for MRI’s and other “advanced imaging services”.  Please give us a call at Insurance Medics if you are shopping around for individual health plans.  We would be happy to provide you with any information you may need.
Source: healthinsurancemedics.com

Don’t Miss the Health Insurance Deduction if You’re Self

If you’re an S corporation shareholder, the policy can be in your name or the S corporation’s name and either of you can pay the premiums. If the policy is in your name and you pay the premiums, the S corporation must reimburse you and include the premiums as wage income on your Form W-2.
Source: irs.gov

Health Insurance Tax Breaks for the Self

For partners, the policy can be either in the name of the partnership or in the name of the partner. You can either pay the premiums yourself or your partnership can pay them and report the premium amounts on Schedule K-1 (Form 1065) as guaranteed payments to be included in your gross income. However, if the policy is in your name and you pay the premiums yourself, the partnership must reimburse you and report the premium amounts on Schedule K-1 (Form 1065) as guaranteed payments to be included in your gross income. Otherwise, the insurance plan will not be considered to be established under your business. 
Source: irs.gov

Medicare Supplement Plans & Quotes

Posted by:  :  Category: Medicare

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

Compare Medicare Advantage & Supplemental Plans

Medicare Advantage insurance is offered by private insurance companies with a Medicare contract, and replaces Original Medicare Part A and Part B. You must continue to pay your Part B premiums. Medicare Advantage plans typically offer additional benefit options and have less cost-sharing than Original Medicare, and you may have to pay a monthly premium in return for the extra benefits. Medicare Advantage plans come in a variety of formats, such as HMO, PPO and PFFS plans, as well as special needs plans. Medicare beneficiaries can enroll in Medicare Advantage plans if they have Medicare Part A and Part B, but only during designated enrollment periods. These enrollment periods change from time-to-time, so please call us to get the most-up-to-date information.
Source: medicaresolutions.com

Medicare Supplement Insurance Quotes : Medicare Supplement Insurance

Medicare Advantage Plans – These are plans that let you access Medicare benefits, the managed care way. Unlike Supplement coverage, Advantage plans offer drug benefits, but on an optional basis. Also, these plans have higher co-pays than Supplement plans. But good news is that you can expect to pay lesser premiums in this category of plans. In fact in certain cases, premiums are as low as $0 and your plan will even shell out a certain part for Medicare Part B.
Source: quickmedicaresupplement.com

Medicare doc fix questions and answers

Posted by:  :  Category: Medicare

How are doctors paid? Doctors are still paid on a fee for service system for their time. When Medicare initially passed in 1965, to get physician support, Congress agreed to preserve the fee for service system. To determine the actual value of physician services, a ratio system (RVRS) was introduced in 1992 that determines the value of one service to another and adjusts for geography. Every five years, an AMA committee (RUC) composed of representatives from each specialty society debates the relative values of physician services and publishes the book that sets these ratios.
Source: kevinmd.com

Medicare Sustainable Growth Rate

Section 101 of the Tax Relief and Health Care Act of 2006 (MIEA-TRHCA) provided a 1-year update of 0% for the conversion factor for CY 2007 and specified that the conversion factor for CY 2008 must be computed as if the 1-year update had never applied. Section 101 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) provided a 6-month increase of 0.5% in the CY 2008 conversion factor, from January 1, 2008, through June 30, 2008, and specified that the conversion factor for the remaining portion of 2008 and the conversion factors for CY 2009 and subsequent years must be computed as if the 6-month increase had never applied. Section 131 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) extended the increase in the CY 2008 conversion factor that was applicable for the first half of the year to the entire year, provided for a 1.1% increase to the CY 2009 conversion factor, and specified that the conversion factors for CY 2010 and subsequent years must be computed as if the increases had never applied.
Source: wikipedia.org

House Passes Medicare ‘Doc Fix’ Bill

WASHINGTON—The House on Thursday overwhelmingly passed a measure to reformulate how Medicare reimburses physicians and other providers, a deal forged in a rare bipartisan alliance between the chamber’s top two leaders.
Source: wsj.com

Medicare ‘doc fix’ bill passes House

In a rare moment of bipartisanship bringing House Speaker John Boehner and House Minority Leader Nancy Pelosi together, the House passed the so called “doc fix.” The House passed it overwhelmingly, 392-37.
Source: cnn.com