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

HyperTerminal Medicare Billing Tutorial

If you do not have a modem you can get an external USB Modem. If you have any computer parts stores in your area give them a call and ask if they have any external USB modems. If you can’t find one locally you can order one from various online retailers. Once you get the modem you will plug it into the USB port on your computer and plug a phone line into the other end. It should also come with a CD to install it. Once the modem is connected and installed you should be able to select the modem in HyperTerminal.
Source: hilgraeve.com

Medicare Billing for Well Woman Exam

1. Cervical High Risk Factors a. Early onset of sexual activity (under 16 years of age) b. Multiple sexual partners (five or more in a lifetime) c. History of a sexually transmitted disease (including HIV infection) d. Fewer than three negative pap smears within the previous 7 years 2. Vaginal Cancer High Risk Factors: DES (diethylstilbestrol) exposed daughters of women who took DES during pregnancy 3. Personal History of Health Hazards: If a patient has a specified personal history presenting hazards to health then apply the V15.89 diagnosis and the appropriate health history hazard (example: V10.3 History of Breast Malignancy).  Any V15.89 diagnosis is considered high risk and makes the patient eligible for the yearly G0101 and Q0091.
Source: capturebilling.com

Medical billing cpt modifiers and list of medicare modifiers.

Care Plan Oversight Services Care Plan Oversight (CPO) is physician supervision of patients under either the home health or hospice benefit where the patient requires complex or multi-disciplinary care requiring ongoing physician involvement. Medicare does not pay for care plan oversight services for nursing facility or skilled nursing facility patients. Separate payment is allowed for the services involved in physician certification/re-certification and development of a plan of care for Medicare covered home health services. Submit HCPCS code G0179 for re-certification after a patient has received services for at least 60 days (or one certification period). HCPCS code G0179 may be reported only once every 60 days, except in the rare situation when the patient starts a new episode before 60 days elapses and requires a new plan of care to start a new episode. Submit HCPCS code G0180 when the patient has not received Medicare covered home health services for at least 60 days. The initial certification (HCPCS code G0180) cannot be filed on the same date of service as the supervision service HCPCS codes (G0181 or G0182). HCPCS Codes G0179: MD re-certification HHA PT G0180: MD certification HHA patient G0181: Home health care supervision G0182: Hospice care supervision How to submit a claim Submit CPT codes 99201-99263 and 99281-99357 only when there has been a face-to-face meeting/encounter HHA / Hospice Provider Number: The requirement to include the HHA or Hospice provider number on a care plan oversight claim for HCPCS codes G0181 and G0182 is waived until further notice, and as a result, claims submitted with the number will be rejected. Dates of service: for HCPCS codes G0181 and G0182, submit the first and last date during which documented care planning services were actually provided during the calendar month. Do not submit the first and last calendar date of the month unless services were provided on those dates) Submit the claim after the end of the month in which the service is performed Report care planning only once per calendar month Report only one month’s services per line item Dates of service: for HCPCS codes G0179 and G0180, submit the date physician signed the certification or re-certification Documentation Claims for care plan oversight services will be denied when review of the beneficiary claims history fails to identify a covered physician service requiring a face-to-face encounter by the same physician during the six months preceding the provision of the first care plan oversight service Medical records for these service must indicate: The physician spent 30 minutes or more for countable care planning activities The specific service furnished, including the date and length of time
Source: medicalbillingcptmodifiers.com

Medical Billing and Coding

Effective immediately please direct all mail, bills and reports for the Sedgwick CMS Oakland and Van Nuys Offices to our new mailing address. Please note this address change only applies to the Oakland and Van Nuys offices which previously used the following addresses: P.O. Box 1027 Van Nuys, CA 91408-1027 P.O. Box 2065 Oakland, CA 94604-0064 New Address: Sedgwick CMS -Sedgwick CMS iVOS MCU P.O. Box 14479 Lexington, KY 40512-4479 Our mailing address has changed; however your claim will continue to be administered from our Oakland and Van Nuys offices by our team of claim professionals. Our phone and fax numbers remain the same. If you are workins with other clients in Oakland and Van Nuvs not usina the addresses listed above, you should continue to use the address they have provided to vou. We look forward to providing quality customer service. If you have any questions, please contact our claims professionals in the appropriate office at their regular number.
Source: whatismedicalinsurancebilling.org

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. 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 single payment amount. The amount is derived from the median of all winning bids for an item.
Source: cms.gov

Competitive Bidding Program areas

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 Guide :: Guide to Medicare Coverage :: The Electric Scoo

Competitive Bidding areas are designated based on the zip code of your permanent residence on file with Social Security. To find out if your zip code is affected by Competitive Bidding, call 1-800-MEDICARE (1-800-4227). You may also visit Medicare.gov and lookup suppliers in your area by zip code (a notice will appear if your area is subject to Competitive Bidding). If medical equipment is marked with a yellow/orange star, it will need to be provided by a contracted supplier (also marked with an orange star).  Throughout this guide, products that are potentially impacted by the competitive bidding program will be designated with a double asterisk **.  Your provider can assist you with answering your questions about competitive bidding and can address whether or not they have been contracted to provide the services you need if subject to competitive bid.
Source: electricscooterstore.com

Rules for Medicare health plans

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

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

3 Medicare Rules You Should Know by Heart

Founded in 1993 by brothers Tom and David Gardner, The Motley Fool helps millions of people attain financial freedom through our website, podcasts, books, newspaper column, radio show, and premium investing services.
Source: fool.com

4 Medicare Advantage Rules to Live By

Founded in 1993 by brothers Tom and David Gardner, The Motley Fool helps millions of people attain financial freedom through our website, podcasts, books, newspaper column, radio show, and premium investing services.
Source: fool.com

Medicare Supplement Insurance Quote Engine

Posted by:  :  Category: Medicare

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 2017 costs at a glance

Posted by:  :  Category: Medicare

The standard Part B premium amount in 2017 is $134 (or higher depending on your income). However, most people who get Social Security benefits pay less than this amount. This is because the Part B premium increased more than the cost-of-living increase for 2017 Social Security benefits. If you pay your Part B premium through your monthly Social Security benefit, you’ll pay less ($109 on average). Social Security will tell you the exact amount you’ll pay for Part B in 2017. You’ll pay the standard premium amount if:
Source: medicare.gov

Notice of Medicare Premium Payment Due (CMS

Follow the instructions on the notice to pay the total amount due by the 25th of the month. You can pay by check, money order, or credit card. Or, sign up for Medicare Easy Pay, a free service that automatically deducts your premium payments from your savings or checking account each month.  
Source: medicare.gov

Medicare Part B Monthly Premium 2017

Actually, these numbers are valid for most persons on Medicare. You will have to pay a higher premium if you filed an individual tax return last year and reported income over $85,000 or $170,000 for a joint return. Depending on the amount of your taxable income, you may have to pay between $187.50 up to the maximum Part B premium of $428.60 per person. Fortunately, income-related adjustments affect less than 5 percent of Medicare beneficiaries. If you have to pay a higher Part B premium because of your income, you should be notified by Social Security.
Source: medicareanswers.org

Turning Medicare Into a Premium Support System: Frequently Asked Questions

An important issue for plans (and consumers) is how the Medicare marketplace would be governed.  In many proposals for a premium support system, it is unclear how the marketplace would be regulated or even which federal agency would regulate it.  Many premium support proposals would maintain an annual open enrollment period, guaranteed issue requirements, and some form of risk adjustment.  However, other factors that affect plans would change or are not specified.  For example, many proposals do not specify whether premiums would be community rated or age-rated, or whether plans would be required to offer Medicare benefits.  Many proposals would also “grandfather” current beneficiaries (not requiring them to enroll in the premium support system) which would create two separate systems – one for beneficiaries who are “grandfathered” and a separate system for new enrollees aging onto the program – and insurers could be required to maintain plans that operate under two different sets of rules and payments.
Source: kff.org

2017 Part D Premium Payment Options

Can I get help paying my premiums and other out-of-pocket costs? People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for 75% or more of your drug costs including, monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify won’t have a coverage gap or a late enrollment penalty. Many people qualify for these savings and don’t even know it. For more information about Extra Help, contact your local Social Security office, or call Social Security at 1-800-772-1213. TTY users should call 1-800-325-0778. You can also apply for Extra Help online at www.socialsecurity.gov/prescriptionhelp. If you qualify for Extra Help with your prescription drug costs you may enroll in, or disenroll from, a plan at any time. If you lose this Extra Help during the year, your opportunity to make a change continues for two months after you are notified that you no longer quality for Extra Help.
Source: cigna.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

More Medicare Information

If you live in Puerto Rico you will not receive Medicare Medical Insurance (Medicare Part B) automatically. You will need to sign up for it during your initial enrollment period or you will pay a penalty. To sign up, please call our toll-free number at 1-800-772-1213 (TTY 1-800-325-0778). You also may contact your local Social Security office. You can find your local Social Security office by using our Office Locator.
Source: ssa.gov

Medicare Information and Plan Comparisons

While health care was not central to the 2016 Presidential campaign, the election’s outcome will be a major determining factor in the country’s future health care policy. A number of issues have garnered media attention, including the future of the Affordable Care Act (ACA), rising prescription drug costs, and the opioid epidemic.
Source: medicare.org

Medicare Information and Guidance On Costs, Coverage

3. Do enroll when you’re supposed to: To avoid permanent late penalties, enroll at age 65 if you don’t have insurance from an employer for whom you or your spouse is still working or if you live abroad without working; or, beyond 65, enroll within eight months of stopping work — even if you continue to receive COBRA or retiree health benefits from an employer.
Source: aarp.org

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

Michigan Medicare Supplemental Plans

Medicare Advantage plans are popular but they’re not your only choice. Don’t want to have to write a check every time you get care? Our other plan options may interest you. You pay a monthly premium for these plans. They pay most of the costs you share with Original Medicare. They may include other benefits too, like coverage for emergency care when you’re traveling.
Source: bcbsm.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

AARP® Medicare Supplemental Insurance by United Healthcare

Medicare Supplement Insurance Plans, insured by UnitedHealthcare Insurance Company. If you’re considering a Medicare supplement plan, talking to an agent/producer may offer the direct assistance you’re looking for.
Source: aarpmedicaresupplement.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

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

How to compare Medigap policies

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 Plans

To be eligible to enroll in a Medicare Supplement plan, you must be enrolled in both Medicare Part A and Part B. A good time to enroll in a plan is generally during the Medigap Open Enrollment Period, which begins on the first day of the month that you are both age 65 or older and enrolled in Part B, and lasts for six months. During this period, you have the guaranteed-issue right to join any Medicare Supplement plan available where you live. You may not be denied coverage based on any pre-existing conditions during this enrollment period (although a waiting period may apply). If you miss this enrollment period and attempt to enroll in the future, you may be denied coverage or charged a higher premium based on your medical history.
Source: ehealthinsurance.com

AARP® Medicare Supplemental Insurance by United Healthcare

Medicare Supplement Insurance Plans, insured by UnitedHealthcare Insurance Company. If you’re considering a Medicare supplement plan, talking to an agent/producer may offer the direct assistance you’re looking for.
Source: aarpmedicaresupplement.com

Medicare: What Are Medigap Plans?

However, you may have to wait up to six months for coverage if you have a pre-existing health condition. The insurer through which you buy your Medigap policy can refuse to cover out-of-pocket costs for pre-existing conditions during that period. After six months, the Medigap policy must cover the pre-existing condition. The exception to this rule is if you buy a Medigap policy during your open enrollment period and have had continuous “creditable coverage,” or a health insurance policy for the six months before buying a policy. The Medigap insurance company cannot withhold coverage for a pre-existing condition in that case.
Source: webmd.com

Medicare Supplemental Plans, Medicare Supplement

Plans F and G are the only Medicare Supplement insurance plans that cover costs known as Medicare Part B excess charges. An excess charge is the difference between what a doctor or provider charges and the amount Medicare will pay. These plans will help protect you from additional out-of-pocket expenses should you need treatment that exceeds what Medicare will approve. Plan F also has a high-deductible option*. Plans F and G cover 100% of the Medicare Part B excess charges.
Source: humana.com

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

Posted by:  :  Category: Medicare

"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

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

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 compare Medigap policies

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

Florida Blue Medicare Advantage Plans for 2017

Are you a Florida senior citizen who is trying to maximize your Medicare benefits? Just as each senior citizen has her own unique needs and preferences, insurers offer a variety of different ways to enjoy these hard-earned health benefits and even help you plan for medical expenses that original Medicare does not completely cover. At Secure Health Options, we want to help all Floridians find the right plan that assures them of convenient and affordable access to the best medical providers. You can request information on 2017 Medicare Advantage plans and Florida Medicare supplemental insurance in your own local area by entering your home ZIP code in the box at the top of this page. If you have questions or would like help signing up, be sure to give us a call.
Source: floridamedicareadvantageplans.com

Medicare Supplement, Life, Dental & Critical Condition Insurance

Posted by:  :  Category: Medicare

Sterling recognizes the vital role providers play as the critical link between patients and their health. Sterling treats providers with the respect they deserve with Medicare Supplement expertise, top-notch customer service, quick and accurate claims processing, and comprehensive tools to manage the administrative process.
Source: cigna.com

Sterling Investors Life Insurance

Founded in 1978 and located in Indianapolis, Indiana, Sterling Investors Life Insurance Company proudly serves the insurance needs to middle class America by providing valuable insurance protection across a broad range of insurance plans. We’re not the biggest so we work very hard everyday to make sure that our policyholders and agents across the country receive a level of service from us that always exceeds their expectations. We believe our company reflects the same conservative values as that of our regional surroundings.
Source: sterlinglifeco.com

Get Medicare Part D Quotes in Seconds

As could be expected, prices for Humana policies rocketed for the 2015 calendar year. Mean premiums for Humana Part D jumped from $21.80 to $38.70. Medicare Part D is priced at $41.55 and Part D Medicare comes in at the slightly lower price of $38.80. Humana’s standalone market share coverage has dropped to 18.6% whereas their Medicare Part D policies have increased to a market share of 12.8%.
Source: medicareaide.com

Medicare Supplement Plan F

* A benefit period begins on the first day you receive service 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. **This high deductible plan pays the same or offers the same benefits as Plan F after you have paid a calendar year $2110 deductible. Benefits from the high deductible Plan F will not begin until out-of-pocket expenses are $2110. Out-of-pocket expenses for this deductible are expenses that would ordinarily be paid by the policy. This includes the Medicare deductibles for Part A and Part B, but does not include the plan’s separate foreign travel emergency deductible.
Source: medigap360.com

Sterling Wealth Management Group

Welcome to our web site, where you’ll find a wealth of information in the form of newsletter articles, calculators, and research reports. We hope your visit will help you understand the opportunities and potential rewards that are available when you take a proactive approach to your personal financial situation. We have created this web site to help you gain a better understanding of the financial concepts behind insurance, investing, retirement, estate planning, and wealth preservation. Most important, we hope you see the value of working with skilled professionals to pursue your financial goals.
Source: sterlingwealthmg.com