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Q: When is it acceptable to collect the deductible from the beneficiary?

by Medical Billing | Nov 17, 2014 | Medicare payment basics

This is the most sighted question from provider. A: When assignment is accepted, Medicare Part B recommends: • Since it is difficult to predict when deductible/coinsurance amounts will be applicable – and over-collection is considered program abuse – do...

Billing Medicare – Medicaid patient . Explanation of different Medicaid plan and its coverage

by Medical Billing | Sep 24, 2014 | Medicare payment basics

Dual Eligible Beneficiaries Dual eligible beneficiaries include individuals who receive full Medicaid benefits as well as those who only receive assistance with Medicare premiums or cost sharing. They must meet certain income and resource requirements and be entitled...

Can we bill patient when Medicare claim denied as timely filing?

by Medical Billing | Aug 29, 2014 | Medicare payment basics

Medicare document says yes but only limited to Deductible and coins. Determination of Untimely Filing and Resulting Actions Medicare denies a claim for untimely filing if the receipt date applied to the claim exceeds 12 months or 1 calendar year from the date the...

Can we submit the claim if patient has provided the backdated card , what is the time limit for secondary claims

by Medical Billing | Apr 9, 2014 | Medicare payment basics

Backdated Medicaid Cards  If a member receives a backdated medical card and the provider wishes to accept it and bill Medicaid for services that occurred over a year ago, the claims must be billed within one year of the issuance of the card.  Claims must be...

How much is Medicaid copay – out of pocket and what are the exemption cases

by Medical Billing | Mar 27, 2014 | Medicare payment basics

Beginning January 1, 2014, some services will be assigned copay amounts for Medicaid Members. The following copays will apply to claims with a date of service on or after January 1, 2014: Service TIER 1 Up to 50.00% FPL   TIER 2 50.01-100.00% FPL    ...
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CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). All Rights Reserved to AMA.
The revenue codes and UB-04 codes are the IP of the American Hospital Association. All Rights Reserved to AMA.
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