1. K

    Question Billing Medicare when VA Authorizes partial services

    Questions for those of you with more knowledge of Medicare vs VA for Acute Inpatient Care in Medicare-certified facility. I don't see clear answers on these issues in CMS's IOM. A client (Medicare-certified Acute Care facility) asks, for patients with both Medicare and VA benefits: 1) Where VA...
  2. K

    Questions regarding Medicare billing secondary to VA (for inpatient Medicare Part A claims)

    Hello, all! I've been tasked with researching four questions related to Inpatient Part A claims where patient has either VA & traditional Medicare Part A, or VA and Medicare HMO/Medicare Advantage. I have limited experience with VA, so any input you can offer is appreciated. Thank you! 1)...
  3. J

    Medicare Secondary allowing more

    I have a patient that came in and had 4 procedures performed. Patient has UHC primary and Medicare secondary. Our UHC only allows 3 procedure codes. The first 3 codes were paid by UHC and the last one was denied CO-97. We then sent the claim to Medicare for the UHC coinsurance. They paid the...