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What else can I help you with?
Patient has Medicare primary and medi cal secondary provider bills Medicare knowing Medicare contract is suspended or pending who then pays claim?
Once Medicare has "adjudicated" the bill, MediCal's payment will be based on their policy and the patient's eligibility on the date of service.
What is the address to submit the Medicare Cms-849 form for the reimbursable amount on a lift chair?
To submit the Medicare CMS-849 form for reimbursement on a lift chair, you should send it to your local Medicare Administrative Contractor (MAC). The specific address can vary based on your location, so it's best to check the Medicare website or contact your MAC directly for the correct address. Make sure to include all required documentation to ensure a smooth processing of your claim.
My mother was just diagnosed with stage 4 cancer. Will her medicare pay for the pet scan the Dr. has asked for Her medical ins. will not.?
In April 2009, Medicare expanded PET scan to include most cancers that are solid tumors. So, this would not cover cancers such as Leukemia, which are blood-based and not solid masses. I do not know what kind of cancer your Mother has. You should still contact Medicare to be completely sure. Another good source would be any hospital Admissions department which makes assessments on Medicare payment eligibility. (Be sure to mention that Medicare is a secondary payor for your Mom, as they will likely assume it is the first payor.)
How many benefit periods are covered by hospital insurance during a Medicare beneficiary's lifetime?
Medicare beneficiaries have an unlimited number of benefit periods covered by hospital insurance during their lifetime. Each benefit period begins when an individual is admitted as an inpatient to a hospital or skilled nursing facility, and ends once they have been out of the hospital or facility for 60 consecutive days.
Will Carle Hospital and Clinic accept Medicare Advantage plan?
Yes, Carle Hospital and Clinic typically accepts Medicare Advantage plans, but acceptance can vary based on specific plan networks and agreements. It's advisable to check directly with Carle or your specific Medicare Advantage provider to confirm coverage and any potential restrictions. Always verify the details before scheduling services to ensure your plan is accepted.
What is the Medicare Part A deductible for 2012?
The Medicare Part A Deductible for 2012 is $1,156 for the first 60 days. $289 per day co-payment from days 61-90 days. $578 per day co-payment from 91-150 days.
What entities process medicare claims?
Medicare claims are primarily processed by Medicare Administrative Contractors (MACs), which are private companies that manage claims for the Centers for Medicare & Medicaid Services (CMS). Additionally, other entities involved in the claims processing include Durable Medical Equipment Medicare Administrative Contractors (DME MACs) for specific equipment claims and Medicare Advantage plans, which may handle claims for beneficiaries enrolled in private insurance plans offering Medicare benefits. These entities evaluate claims for accuracy and determine payment based on Medicare guidelines.
How much does medicare pay for transportation to ins companies?
Nothing, Medicare does not provide and does not cover transportation to get routine health care and never covers transportation of any type to an INS company for any reason.. Medicare will pay for limited ambulance services. If you go to a hospital or skilled nursing facility (SNF), ambulance services are covered only if transportation in any other vehicle could endanger your health. Generally, transportation from a hospital or SNF is not covered. If the care you need is not available locally, Medicare helps pay for necessary ambulance transportation to the closest facility outside your local area that can provide the care you need. If you choose to go to another facility farther away, Medicare payment is based on how much it would cost to go to the closest facility. All ambulance suppliers must accept assignment.Medicare does not pay for ambulance transportation to a doctor's office.
Is medicare tax calculated on COLA payments?
If the COLA is on something, like a contract wage, that was FICA taxable, then yes. The FICA taxableness is based on what the payment is actually for...not how it's calculated (which is what the COLA does).
How much does a medicare doctor get paid per month?
The monthly payment for a doctor accepting Medicare varies widely based on factors such as their specialty, location, and the volume of patients they see. On average, Medicare reimbursement rates for services are typically lower than those from private insurance. A primary care physician might earn between $10,000 to $20,000 monthly from Medicare, while specialists could earn more. However, actual income can fluctuate significantly based on practice management and patient demographics.
How can you get your medical record?
Usually you just submit a request in writing to the doctor's office or hospital. In most states they must give them to you within a certain period of time (20 business days is common) but they are allowed to charge a fee for them. They usually are not allowed to withhold them until payment for other services are rendered.
I understand when Medicare is primary and when Medicare is secondary. What is the difference in coverage between a Medicare Supplement and Medicare as a secondary insurer?
If you have a Medicare Supplement then the provider will bill Original Medicare first. At that time Medicare will pay the allowable amount and then return an explanation of benefits stating the beneficiary's portion. Based on the Medicare Supplement Plan that is in place (A-N) the Medicare Supplement will pay a portion or all of the remaining amount due. If they pay only a portion based on the plan (A-N), then according the plan guidelines, the beneficiary would pay any outstanding amount at that time. If a Medicare beneficiary is covered on a employer or retiree group plan and due to the size of the plan, the group plan is primary, then the group plan benefits will apply first and any amounts due by the Beneficiary will be billed to Medicare second. If it is a Medicare covered service, then Medicare will pay the remaining amount due as the secondary payor up to the amount allowed by Medicare. If the service is not allowed by Medicare, than the beneficiary's co-insurance or co-payment under the group plan would be their responsibility.
