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 Information, Help, and Plan Enrollment

Humana is a Medicare Advantage [HMO, PPO and PFFS] organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or member cost-share may change on January 1 of each year.
Source: medicare.com

Medicare.gov: el sitio oficial del gobierno de EE. UU. para Medicare

No se pudo cargar la página. Actualmente, la página de inicio de Medicare.gov no admite navegadores con "JavaScript" desactivado. Tenga en cuenta que si decide continuar sin activar "JavaScript", es posible que determinadas funciones en este sitio web no estén disponibles.
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

Medicare Part B moves to NGS Saturday

Posted by:  :  Category: Medicare

The Wisconsin Medical Society continues to work closely with NGS to ensure a smooth transition to the new Medicare Part B MAC for J6. As part of this effort, Society Director of Educational Strategies Jen Cohrs CPC, CPMA, CGIC, and Christine Obergfell, CPC, from NGS offered a complimentary webinar NGS Transition for Part B Providers earlier this summer. The webinar is available for viewing at no cost via the Society’s Continuing Education Center.
Source: wisconsinmedicalsociety.org

National Government Services, the MAC for jurisdiction 13, issues coding guidance for CPT code 77427

National Government Services (NGS), the Medicare Administrative Contractor (MAC) for jurisdiction 13 (Connecticut and New York) released the document “Clarification on the Proper Reporting of Radiation Treatment CPT Code 77427″ to advise providers on what they believe is the proper way to report this code. For CPT code 77427 NGS requires that: In the event five fractions occur in two different calendar months or years, the billing “from and to” dates should reflect the month in which the most fractions were performed. For example: if two fractions were performed on 1/30/09 and 1/31/09, and three fractions were performed on 2/1/09, 2/2/09 and 2/3/09, the claim would be billed with a “from date” of 2/1/09 and “to date” of 2/3/09. ASTRO submitted a comment letter to NGS stating that neither the ASTRO/ACR Guide to Radiation Oncology Coding nor the Medicare Claims Processing Manual requires physicians to report this code for the month in which the most fractions occur if treatment extends into different calendar years or months and that we would like to know NGS’ rationale in making this coding determination. NGS explained that the reason they are requiring providers to only bill the “from and to” dates for the months in which the most fractions occur is because their multicarrier system cannot process claims that cross years or months. NGS states that the only other billing alternative is to split the week and have one line deny because the fractions are less than three and allow the other detail to process because the fractions are ≥3. For example, five fractions were incurred from 2/28/12-3/3/12. The provider would bill 2/28/12-2/29/12 for two fractions and be denied because the fractions are not ≥ three and bill the remaining three fractions, 3/1/12-3/3/12 and be paid for the full week. ASTRO explained that CPT code 77427 can be reported if there are three or four fractions beyond a multiple of five at the end of a course of treatment and requested clarification on how their system will process claims for those three or four fractions. For example, four fractions are incurred from 2/28/12-3/2/12. The provider would bill 2/28/12-2/29/12 for two fractions and be denied because the fractions are not ≥ three. The provider would bill the remaining weekly management 3/1/12-3/2/12 and be denied because the fractions do not equal ≥ three. NGS replied that the provider would need to request a review of the claim providing documentation that this has occurred, i.e., the remaining fractions of the course of treatment were two in one month and two in another month. This review would take place after the initial claim submission and determination. CPT code 77427 is used by radiation oncologists for weekly management of a patient and is reported in units of five fractions or treatment sessions regardless of the actual time period in which the services are furnished. This code may also be reported if there are three or four fractions beyond a multiple of five at the end of a course of treatment. CPT code 77427 represents the radiation oncologist’s professional contribution to patient management and is typically reported on the date of the fifth treatment or the third treatment if it is the last week. ASTRO is actively monitoring the issue and is interested in hearing from our members. If you would like to share your experience with NGS or another MAC regarding the processing of claims for CPT code 77427, please contact Marsha Kaufman.  
Source: astro.org

Medicare Information, Help, and Plan Enrollment

Humana is a Medicare Advantage [HMO, PPO and PFFS] organization with a Medicare contract. Enrollment in any Humana plan depends on contract renewal. This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments and restrictions may apply. Benefits, premiums and/or member cost-share may change on January 1 of each year.
Source: medicare.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

National Government Services

National Government Services is one of the few organizations in the federal health care market that has true roots in health care and a history of delivering solutions that solve complex challenges. Our capabilities are designed to be flexible, scalable, and most importantly the right fit to meet our customers’ demands.
Source: ngsservices.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

What’s Medicare Supplement Insurance (Medigap)?

Posted by:  :  Category: Medicare

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

Supplements & other insurance

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

Palmetto GBA : Search Help

Posted by:  :  Category: Medicare

Should you have landed here as a result of a search engine (or other) link, be advised that these files contain material that is copyrighted by the American Medical Association and/or American Dental Association. Current Dental Terminology, fourth edition (CDT-4) (including procedure codes, definitions (descriptions) and other data) is copyrighted by the American Dental Association. Copyright 2002 American Dental Association. All rights reserved. Applicable FARS/DFARS apply. You are forbidden to download the files unless you read, agree to, and abide by the provisions of the copyright statement.
Source: palmgba.com

What Is Palmetto Gba Medicare?

Palmetto GBA (Government Benefits Administrators) is a wholly owned subsidiary of BlueCrossBlueShield of South Carolina. The company is headquartered in Columbia, SC. Palmetto GBA has administered complex transaction processing for the Centers of Medicare and Medicaid (CMS) since the inception of Medicare in 1965. They have employees in 14 states.
Source: insurancelibrary.com

Local Coverage Determinations (LCDs) for Palmetto GBA (11302, MAC

NOTE: You either have javascript disabled or have saved the page locally. Your experience may not be optimal due to these factors. Please consider enabling javascript or revisiting this page to get an optimal MCD experience. (Due to browser security settings, directly clicking the previous link may not work, so you may need to copy and paste the following link [http://www.cms.gov/medicare-coverage-database/indexes/lcd-list.aspx?Cntrctr=229&ContrVer=1&CntrctrSelected=229*1&name=Palmetto+GBA+(11302%2c+MAC+-+Part+B)&LCntrctr=229*1&bc=AgACAAAAAAAA&] into your browser.)
Source: cms.gov

Understanding Indemnity Health Insurance Plans

Posted by:  :  Category: Medicare

Unlike HMO and PPO health insurance plans, most indemnity policies allow you to choose any doctor and hospital that you wish when seeking health care services. Indemnity plans are considered fee-for-service health insurance plans. This means that you have the freedom to choose your health care services and as long as your services are eligible you will be charged a fee depending on how your policy rules are written. Sometimes indemnity health insurance plans cost more than HMOs and PPOs, but the payoff is the flexibility of choices.
Source: about.com

Coventry Medicare: Advantra Plans

Posted by:  :  Category: Medicare

Our Medicare Advantage plans are open to all Medicare beneficiaries eligible by age or disability and living in the plan’s service area. You must be entitled to Medicare benefits under Part A and be enrolled in Part B. You must continue to pay your Medicare Part B premium if not otherwise paid for under Medicaid or by another third party. If you switch to premium withhold or move from premium withhold to direct bill, it can take up to three months for the switch to take effect. You will be held responsible for those premiums.  You may enroll during specific times of the year. You cannot enroll in this plan if your current or former employer helps pay for your drugs.  For information on enrollment periods and for full information on Coventry benefits, please click here to contact our Customer Service Department.
Source: coventryhealthcare.com

Coventry Medicare: Advantra (HMO/PPO)

Whether you are an employer, health care provider, someone interested in enrolling, or already a current member, our goal is to provide you with valuable and convenient online resources and information. Come explore the ways in which we can help you take charge of your Medicare Advantage coverage.
Source: coventryhealthcare.com

HealthAmerica/HealthAssurance: Home

For existing members, to obtain the terms of your policy or a copy of your plan document, please contact us at the number located on the back of your member ID card. If you are not an existing member, for additional information on the terms of the policy or a copy of the plan document, please contact us using the phone number under the Contact Us tab.
Source: coventryhealthcare.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

Blue Cross Blue Shield Medicare Coverage

Posted by:  :  Category: Medicare

You can think of Medicare as a safety net. But even a safety net can have holes. Medicare covers many of your health care expenses. But it was never designed to pay all your health care costs. If you rely only on it to cover all your medical and/or prescription drug expenses, you could come up short. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, has options to strengthen your Original Medicare safety net with:
Source: bcbstx.com

Blue Cross Blue Shield Medicare Coverage

This link will take you to a new site not affiliated with BCBSTX. It will open in a new window. To return to our website, simply close the new window. Refer to important information for our linking policy.
Source: bcbstx.com

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