In Billing
Mar 14th, 2018
The Qualified Medicare Beneficiary (QMB) information in the Medicare remittance advice (RA) and Medicare summary  notice is being reintroduced; the issues preventing the processing of QMB cost-sharing claims by states and other secondary payers have been resolved. The simple fix was to include revised “alert” Remittance Advice Remark Codes in RAs for QMB claims without adopting other ...
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 ...