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Handling Medicaid and HMO retroactive eligibility?

by Medical Billing | Oct 12, 2016 | Medicare payment basics

RETROACTIVE ELIGIBILITY Providers should be aware that, since bills have to be incurred before the deductible amount is met, there is always a period of retroactive eligibility. This may be several days or up to a period of three months from the current month. In this...

How to handle Retroactive Medicare entitlement

by Medical Billing | Oct 8, 2016 | Medicare payment basics

 Retroactive Medicare Entitlement The time for filing a claim will be extended if CMS or one of its contractors determines that a failure to meet the filing deadline is caused by all of the following conditions: (a) At the time the service was furnished the...

Does careplus cover diabetes and cardiovascular disorder ?

by Medical Billing | Jul 17, 2013 | Medicare payment basics

 Eligibility Requirements for Diabetes SNP – CareDirect (HMO SNP) * Entitled to Medicare Part A  * Enrolled in Medicare Part B through age or disability * Resident within the Plan’s service area * Diagnosed with diabetes mellitus (ICD-9-CM codes 250.xx) *...

Eligibility verification throught Medicare IVR – Information required

by Lori | Mar 22, 2011 | Medicare payment basics

Eligibility Options Available via the Jurisdiction A DME MAC IVR The DME MAC A Call Center has seen an increase of calls due to eligibility denials for a Medicare beneficiary.  Some of the common ANSI denials associated with eligibility include, but aren’t...

Medicare benefits for Abdominal Aortic Aneurysm (AAA) Screening

by Lori | Mar 15, 2011 | Medicare payment basics

Abdominal Aortic Aneurysm (AAA) Screening Abdominal Aortic Aneurysm (AAA) is a vascular disease with life-threatening implications. If you have a family history of abdominal aortic aneurysm or have smoked at least 100 cigarettes in your lifetime, you are considered at...
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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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