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This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
Medicare applies a MPPR to the payment of select therapy services. The reduction applies to HCPCS codes contained on the list of “always therapy” services, regardless of the type of provider or supplier furnishing the services. Find out the…
Providers may be billing these services incorrectly. Please review this article and pay close attention to the billing loop and segment information detailed within. The NCT number has been added to the instructions.
The requirements for the submission of claims under reciprocal billing and fee-for-time compensation arrangements are the same for assigned and non-assigned claims. This article shows when these requirements apply.
Medicare pays for cardiac rehabilitation (CR), intensive cardiac rehabilitation (ICR), and pulmonary rehabilitation (PR) programs if specific criteria are met. This criterion includes coverage provisions for CR, ICR, and PR items and servic…
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the elements of a model compliance plan.
Some clinical laboratories in our jurisdiction are charging patients prior to performing services, a potential assignment violation. This article outlines Medicare regulations and potential penalties applicable to laboratories.
Do you want to know how to avoid MSP claims payment delays and inappropriate denials?
Use this article as a quick reference for billing claims where Medicare is the secondary payer.
Medicare will pay for Kisunla for monoclonal antibodies directed against amyloid for the treatment of Alzheimer's disease. Please review this article and pay close attention to the billing instructions detailed within.