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...
Stay in line with private carrier rules and follow updated Medicare and Medicaid guidance. Balance billing is charging the patient for any balance on their account after insurance has paid its portion. The question on everyone’s mind is: Does the patient truly owe the balance after insurance pays? The simple answer is, if there is ...