Medicare Billing: Wheelchairs, Scooters, Lift Chairs at SpinLife

Posted by:  :  Category: Medicare

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

Medicare Supplement, Life, Dental & Critical Condition Insurance

A Note about Member Confidentiality:&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp&nbsp Sterling adheres to the Health Insurance and Portability and Accountability Act of 1996 (HIPAA) requirements and considers member information confidential. We adhere to the most stringent state and federal guidelines in handling and storing information. As a provider, you may call Sterling to inquire about benefits or claims status. To be sure that all callers, including providers, are eligible to discuss Protected Health Information (PHI), our call center representatives will request a few data elements for verification: &nbsp&nbsp&nbsp&nbsp&nbsp&nbsp
Source: cigna.com

eCFR — Code of Federal Regulations

Posted by:  :  Category: Medicare

(3) When Federal funds apportioned under 23 U.S.C. 402 are expended by a State agency for the benefit of a political subdivision, such funds may be considered as part of the local share, provided that the political subdivision has had an active voice in the initiation, development, and implementation of the programs for which such funds are expended. A State may not arbitrarily ascribe State agency expenditures as “benefitting local government.” Where political subdivisions have had an active voice in the initiation, development, and implementation of a particular program or activity, and a political subdivision which has not had such active voice agrees in advance of implementation to accept the benefits of the program, the Federal share of the cost of such benefits may be credited toward meeting the local participation requirement. Where no political subdivisions have had an active voice in the initiation, development, and implementation of a particular program, but a political subdivision requests the benefits of the program as part of the local government’s highway safety program, the Federal share of the cost of such benefits may be credited toward meeting the local participation requirement. Evidence of consent and acceptance of the work, goods or services on behalf of the local government must be established and maintained on file by the State until all funds authorized for a specific year are expended and audits completed.
Source: ecfr.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

The Medicare Part D Prescription Drug Benefit

Medicare Part D is a voluntary outpatient prescription drug benefit for people on Medicare that went into effect in 2006. All 57 million people on Medicare, including those ages 65 and older and those under age 65 with permanent disabilities, have access to the Part D drug benefit through private plans approved by the federal government; in 2016, nearly 41 million Medicare beneficiaries are enrolled in Medicare Part D plans. During the Medicare Part D open enrollment period, which runs from October 15 to December 7 each year, beneficiaries can choose to enroll in either stand-alone prescription drug plans (PDPs) to supplement traditional Medicare or Medicare Advantage prescription drug (MA-PD) plans (mainly HMOs and PPOs) that cover all Medicare benefits including drugs. Beneficiaries with low incomes and modest assets are eligible for assistance with Part D plan premiums and cost sharing. This fact sheet provides an overview of the Medicare Part D program and information about 2017 plan offerings, based on data from the Centers for Medicare & Medicaid Services (CMS) and other sources.
Source: kff.org

How do you look up your Medicare number?

A Medicare number includes a person’s social security number followed by a small code that consists of letters or letters with numbers depending on various factors. It is also called a Medicare claim number on documents from the provider. Because the number is primarily made up of a person’s social security number, it is not easy to look it up if lost or forgotten.
Source: reference.com

Medicare Part D Donut Hole – Prescription Drug Coverage Gap

Posted by:  :  Category: Medicare

Most Medicare Part D Prescription Drug Plans have a coverage gap, sometimes called the Medicare “donut hole.” This means that after you and your Medicare drug plan have spent a certain amount of money for covered prescription drugs, you then have to pay all costs out-of-pocket for the drugs, up to a certain out-of-pocket limit. The yearly deductible, coinsurance, or copayments, and what you pay while in the coverage gap, all count toward this out-of-pocket limit. The limit doesn’t include the drug plan’s premium.
Source: ehealthmedicare.com

Zurik: Insurers pushing Medicare clients into the donut hole

At this point the patient enters Medicare’s coverage cap, also known as the donut hole. And here is where they feel a bigger pain in their pocketbook. The patients in the donut hole for the next $3,700 in drug costs. The insurance company’s portion drops from 75 percent to 10 percent, while the patient’s costs increases to 40 percent. The remaining 50 percent is actually a drug manufacturer’s discount, given to the insurance company. The donut hole’s expense breaks down like this: the insurance company pays $370 while a patient is on the hook for $1,480.
Source: fox8live.com

Compare Medicare Advantage & Supplemental Plans

Medicare supplement plans offer benefits in addition to the benefits offered by Original 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 licensed sales 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

Survive the Medicare Part D doughnut hole, donut hole, how to save on
prescription drugs, 9 ways to pay for prescription drugs in the donut hole

6. Comparison shop   There are great differences in drug prices from outlet to outlet. Go in and ask them. Wal-mart has reduced the prices on select drugs to $4 each, and Target  and others have come out with their own plans. The Giant Eagle Supermarket chain in my area has just reduced 400 prescriptions to a $4 price. Yesterday I read about a Midwest chain that was giving 7 different antibiotics for FREE. I am so sorry that I did not keep the name. Giant Food, the Landover, MD based retailer, began a special promotion for the three months beginning January 1, 2009. Thirty six generic antibiotics are FREE. Yes FREE! Watch for other unique promotions like this from competing retailers.  Read Generic Drug Alert. The article is at the bottom of that page when you click on the link. This article is important for the next area as well. 
Source: seniorark.com

Health Insurance, Medicare Insurance and Dental Insurance

Posted by:  :  Category: Medicare

At Humana, we go beyond insurance. We help provide a roadmap to a healthier you. By taking a personalized look at your life and your health, we can help you find the perfect plan and achieve your goals. Start becoming your best you. Start with healthy.
Source: humana.com

Health Insurance Plans for Individuals & Families, Employers, Medicare

UnitedHealthcare offers health insurance plans to meet the needs of individuals and employers. Plus we offer dental, vision and many other insurance plans to help keep you and your family healthy. 
Source: uhc.com

Medical Billing and Coding

Posted by:  :  Category: Medicare

P.O. Box 1051 Augusta, GA 30903-1051 Usually Medicare does not accept primary paper claim so please find out the payor id and submit the claims electronically. Here is the updated list of Medicare all state phone number and payor id, Its usually change to different clearing house hence double confirm before doing any setup.
Source: whatismedicalinsurancebilling.org

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

How to Appeal a Medicare Claim Denial Decision

In addition, Medicare Advantage companies must give patients a way to report grievances about the plan and the quality of care they receive from providers in the plan. If you have a Medicare Advantage plan, look at your plan materials or contact the plan administrator for information about filing a grievance or an appeal. For more details, see the Medicare publication “Your Medicare Rights and Protections” or "Medicare Advantage Plans and Medicare Cost Plans: How to File a Complaint (Grievance or Appeal)."
Source: aarp.org

The United States Social Security Administration

Posted by:  :  Category: Medicare

Social Security was created in 1935 to promote the economic security of the nation’s people. Since then, we’ve integrated programs and services to support millions of people. Get to know your Social Security and learn about our commitment to help secure today and tomorrow.
Source: ssa.gov

Social Security Office for Germantown, MD 20876

Social Security Office Directions and Notes :FROM THE NORTH: TAKE I-270 SOUTH TO EXIT 6A, MD-28/W MONTGOMERY AVE TOWARD ROCKVILLE. TURN LEFT ONTO MD-28/W MONTGOMERY AVE. CONTINUE ONTO MD-28/W JEFFERSON ST. TURN LEFT ONTO N WASHINGTON ST. THE OFFICE IS ON THE RIGHT. FROM THE SOUTH: TAKE I-270 NORTH TO EXIT 5, MD-189/FALLS ROAD. KEEP RIGHT AT THE FORK AND MERGE ONTO MARYLAND AVE. AFTER 1 MILE, TURN LEFT ONTO E MIDDLE LANE. TAKE THE 2ND RIGHT ONTO N WASHINGTON ST. THE OFFICE IS ON THE RIGHT.
Source: socialsecurityhop.com

Apply for Disability in Maryland

By submitting above, I agree to the privacy policy and disclaimer and consent to be contacted by an agent via phone call or text message at the phone number(s) listed above, including wireless number(s). Calls may be auto-dialed/pre-recorded. Consent is not required to utilize our services.
Source: disability-benefits-help.org

Social Security (United States)

Due to changing needs or personal preferences, a person may go back to work after retiring. In this case, it is possible to get Social Security retirement or survivors benefits and work at the same time. A worker who is of full retirement age or older may (with spouse) keep all benefits, after taxes, regardless of earnings. But, if this worker or the worker’s spouse are younger than full retirement age and receiving benefits and earn “too much”, the benefits will be reduced. If working under full retirement age for the entire year and receiving benefits, Social Security deducts $1 from the worker’s benefit payments for every $2 earned above the annual limit of $15,120 (2013). Deductions cease when the benefits have been reduced to zero and the worker will get one more year of income and age credit, slightly increasing future benefits at retirement. For example, if you were receiving benefits of $1,230/month (the average benefit paid) or $14,760 a year and have an income of $29,520/year above the $15,120 limit ($44,640/year) you would lose all ($14,760) of your benefits. If you made $1,000 more than $15,200/year you would “only lose” $500 in benefits. You would get no benefits for the months you work until the $1 deduction for $2 income “squeeze” is satisfied. Your first social security check will be delayed for several months—the first check may only be a fraction of the “full” amount. The benefit deductions change in the year you reach full retirement age and are still working—Social Security only deducts $1 in benefits for every $3 you earn above $40,080 in 2013 for that year and has no deduction thereafter. The income limits change (presumably for inflation) year by year.
Source: wikipedia.org

Social Security Administration Office in Baltimore, Maryland with Reviews

- helps you find the right local businesses to meet your specific needs. Search results are sorted by a combination of factors to give you a set of choices in response to your search criteria. These factors are similar to those you might use to determine which business to select from a local Yellow Pages directory, including proximity to where you are searching, expertise in the specific services or products you need, and comprehensive business information to help evaluate a business’s suitability for you. “Preferred” listings, or those with featured website buttons, indicate YP advertisers who directly provide information about their businesses to help consumers make more informed buying decisions. YP advertisers receive higher placement in the default ordering of search results and may appear in sponsored listings on the top, side, or bottom of the search results page.
Source: yellowpages.com

Compare Medicare Advantage & Supplemental Plans

Posted by:  :  Category: Medicare

Medicare supplement plans offer benefits in addition to the benefits offered by Original 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 licensed sales 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

A Guide to Medicare Supplemental Companies

Christian Fidelity Life Insurance Company was established in 1954 and specializes in Phoenix, AZ providing life and health insurance coverage to the senior citizens. The company is located in and functions as a subsidiary of Oxford Life Insurance Organization. Christian Fidelity Life is actually a superb quality Final Expense Life Insurance and Medicare Supplement dispensing insurance company with excellent sales workforce, outstanding service and highly competitive premiums. Presently, about 30,000 insured persons being offered individual Supplemental Medicare insurance products. The company owns assets worth $90,802,891, a capital equaling $3,630,000 and a net surplus amounting to $41,934,621. Christian Fidelity Life Insurance Company has been graded with B++ (GOOD) rating by the A.M.Best Company. The two main insurance products provided by Christian Fidelity Life are Medicare Supplement and Life Insurance. The Supplemental Medicare plans offered by the company helps in covering the expenses left behind by Medicare, for example: Medicare Part A deductibles & co-payments, doctor services, outpatient services & supplies, emergency health care (outside U.S.), ambulance services, skilled nursing facility, speech therapy and extended hospital care. The other main type of insurance, provided by Christian Life is Life Insurance with a special whole life insurance plan known as Assurance Final Expense. This whole life policy is offered to the individuals aged from 50 to 85 years. The policy gives coverage for the funeral costs and other expenses when the insured person passes away.
Source: bestmedicaresupplement.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

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

Health Insurance Plans for Individuals & Families, Employers, Medicare

UnitedHealthcare offers health insurance plans to meet the needs of individuals and employers. Plus we offer dental, vision and many other insurance plans to help keep you and your family healthy. 
Source: uhc.com

Medicare Supplemental Insurance — Which policy is best?

Our recommendation: After picking the benefit combination (Plan A through L) that best suits your needs, buy the issue-age or community-rated Medigap policy with the lowest premium. Even though they are a bit more expensive at the start, your premiums won’t go up every year just because you get older. (AARP’s Medigap plans use a combination of issue-age and community-rated methods; their premiums don’t increase as you get older, but their younger retirees do receive a discount.)
Source: todaysseniors.com

Health Insurance, Medicare Insurance and Dental Insurance

At Humana, we go beyond insurance. We help provide a roadmap to a healthier you. By taking a personalized look at your life and your health, we can help you find the perfect plan and achieve your goals. Start becoming your best you. Start with healthy.
Source: humana.com

Assisted Living Facilities .org

Posted by:  :  Category: Medicare

AssistedLivingFacilities.org strives to serve as the informational resource for assisted living in the United States. We list information on over 36,400 state-licensed assisted living facilities and try to explain the rules and regulations of each state. We try to offer as much useful information as possible to help you decide if assisted living is a good option, and if so, to select the best facility possible.
Source: assistedlivingfacilities.org

Costs, Expenses and How To Pay for Assisted Living

As far as Medicaid and Long-Term Care goes, it essentially pays for ‘basic’ nursing home care with no unnecessary amenities, or extras. Medicaid reimbursement rates are usually set by the state, and not by the assisted living facility or nursing home – and these rates are often set at a lower rate than what would be paid by other insurance sources. This essentially means that unfortunately, many assisted living facilities will not accept Medicaid patients, since they are likely to make less money from them. Eligibility for Medicated differs from state-to-state, but it is based on the individual having minimal income and few other financial resources and assets. To learn more about Medicaid, as well as eligibility and an excellent overview of the program, please visit the Centers for Medicare & Medicaid services site, which is a division of the U.S. Department of Health and Human Services, or call 800-MEDICARE.
Source: assisted-living-directory.com

Workers’ compensation and payments

Posted by:  :  Category: Medicare

If you settle your workers’ compensation claim, you must use the settlement money to pay for related medical care before Medicare will begin again to pay for related care. In many cases, before a settlement is reached, the workers’ compensation agency asks Medicare to approve an amount to be set aside to pay for future medical care. Medicare will look at certain medical documentation and approve an amount of money from the settlement. This money must be used up first before Medicare starts to pay for related care that’s otherwise covered and reimbursable by Medicare.
Source: medicare.gov

MSA Frequently Asked Questions

A WCMSA meets CMS’ criteria for review when: A.The Claimant is currently a Medicare beneficiary and the total settlement value is greater than $25,000. -or- B. The Claimant has a “reasonable expectation“ of Medicare enrollment within thirty (30) months of the settlement date and the anticipated total settlement amount for future medical expenses and disability/lost wages over the life or duration of the settlement agreement is expected to be greater than $250,000. Claimants have a “reasonable expectation” of enrollment where: (1) The claimant has applied for Social Security Disability Benefits. (2) The claimant has been denied Social Security Disability Benefits but anticipates appealing that decision. (3) The claimant is in the process of appealing a denial of or re-filing for Social Security Disability benefits. (4) The claimant is 62 years and 6 months old. (5) The claimant has an End-Stage Renal Disease (ESRD) condition but does not yet qualify for Medicare based upon ESRD. CMS has noted that while they do not wish to review WCMSAs if the thresholds are not met, these thresholds reflect a CMS operational workload standard only. They do not constitute a substantive dollar or “safe harbor” threshold. Medicare beneficiaries must still consider Medicare’s interests in all WC cases and ensure that Medicare is secondary payer to workers’ compensation. 5/11/11 Memorandum, Charlotte Benson, Acting Director, Financial Services Group. See also, WCMSA Reference Guide, cms.gov
Source: atlassettlements.com

Workers’ Compensation Medicare Set Aside Arrangements

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

Future Medical Allocation Services

GRG’s evaluation in workers’ compensation and third party liability cases includes satisfying Medicare’s past interests – reimbursement for conditional payments – and evaluating / satisfying Medicare’s future interests – identifying Future Medical Allocations and providing compliant spend-down options to ensure Medicare is not billed prematurely.
Source: garretsongroup.com