Nov 15th, 2017
On Oct. 2, 2017, Change Request 9911 modified the Medicare Remittance Advice (RA) for Qualified Medicare Beneficiary (QMB) claims to identify QMB patients and reflect zero cost-sharing liability. As a result, certain payers secondary to Medicare were unable to process direct-billed claims because patient responsibility deductible and coinsurance amounts on the Medicare Remittance Advice (RA) showed...
May 1st, 2012
Weed through the guidance to properly append this commonly confused modifier. By G.J. Verhovshek, MA, CPC, and Rita Von Holtum, CPC-H Nearly 18 months since its introduction at the American Medical Association’s (AMA’s) 2010 CPT® Symposium, modifier 33 Preventive service continues to cause confusion. Here, we review eight quick tips that teach you when and ...
In Billing
Feb 10th, 2012
Most patients don’t realize the differences among screening, diagnosis, and treatment. When a patient comes into the office for a preventive visit and it turns into acute care, many patients think their insurance will cover the bill. In actuality, the “free preventive care” that results in a diagnosis or follow-up treatment is not considered a ...
In Billing
Jul 2nd, 2010
After President Barack Obama signed legislation June 25 granting a 2.2 percent update to physicians’ Medicare payments, the Office of Inspector General (OIG) the same day waived a Medicare regulation that would require providers to bill patients for additional coinsurance relative to the rate increase, which is retroactive to June 1. Physicians May Waive Coinsurance During ...
In CMS
Apr 16th, 2010
The Centers for Medicare & Medicaid Services (CMS) issued on April 6 its final rule implementing policy and technical changes to the Medicare Advantage (Part C) and Medicare prescription drug benefit programs (Part D). That same day, CMS announced that capitation rates for Medicare Advantage (MA) plans in 2011 will be unchanged from this year. ...