When a Medicare patient has multiple sources of insurance coverage, Medicare will only pay for services after the primary payer has processed the claim and made their payment. Medical office staff must always verify the patient's insurance coverage thoroughly - gathering all necessary information from the primary insurance, such as policy numbers, claim submission instructions, and any preauthorization requirements, etc.
Topics: Practice cash flow, payer contract, carrier contract, carrier contract guidelines, medicare compliance, patient billing, claims, insurance
Whether you are new to Practice Management Institute, a certified professional, enrolled in, or inquired about medical office training, you have probably interacted with Kathleen Riexinger at some point. She has worked with PMI for two decades and recently received a well-deserved promotion to Director of Student Experience. She chose the new title, said PMI President/CEO David T. Womack, and it fits her to a tee.
Topics: Practice management, medical office manager topics, medical practice issues, medical office staff, administrative burdens, medical office leadership, medicare compliance
Topics: carrier contract guidelines, medical billing, Medicare fraud, medicare compliance, patient billing
The U.S. Department of Justice (DOJ) on May 26 announced law enforcement actions for several COVID-19-related Medicare fraud schemes totaling $143 million. The actions involved the exploitation of Centers for Medicare and Medicaid Services (CMS) policies designed to increase access to care during the COVID-19 pandemic. Fourteen defendants were charged for their actions involving the exploitation of the broadened COVID-19 emergency declaration, telehealth regulations, and rules.
Topics: medical office compliance, medical fraud, Medicare fraud, medicare compliance