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This article includes a quick reference table that will help the billing staff of providers, physicians, and other suppliers determine whether Medicare is the primary or secondary payer based upon specific situational criteria. The informat…
This information outlines the process for the 935 recoupment.
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
Effective January 1, 2024, IOP services are available for both individuals with mental health conditions and individuals with substance use disorders. This article addresses institutional billing requirements for these new services.
The Jimmo Settlement Agreement clarifies Medicare’s longstanding policy coverage of skilled nursing and skilled therapy services. Please read this article and access the link within the article for more information.
Read this article to learn more about billing a skilled nursing facility (SNF) leave of absence claim.
Read the below article for more information on MSP ongoing responsibility for medicals.
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.
If you’re a new or seasoned provider billing dental services to fee-for-service (FFS) Medicare, or original Medicare, this article guides you through recently clarified payment provisions for dental services in 2023, the provider enrollment…
When a patient enrolls in or disenrolls from a Medicare Advantage plan during his/her inpatient stay, the following factors will determine whether to bill the Medicare Advantage plan and/or original Medicare.