Tag: Medicare provider

How Often Should Chiropractors Have Their Patients Sign A New Advance Beneficiary Notice (ABN)?

Over the years I have come to grasp that ABNs although very useful are quite difficult to implement appropriately for chiropractic practices. My goal for this article is to help practices understand how often ABNs should actually be signed by their Medicare beneficiary patients. A question I am typically asked about ABNs is when should a patient sign a new one? Many offices have the misconception that a new ABN should be signed by Medicare beneficiaries at the beginning of each year which is not the case.

Medicare only requires that the ABN form be completed before the first spinal chiropractic manipulative treatment is rendered for maintenance, wellness, palliative, and/or supportive care. Until one of the following takes place the ABN remains active:

In the event a new condition or active treatment is initiated the current ABN would be rendered invalid because the active treatment would likely meet Medicare’s medical necessity guidelines and be considered eligible for payment again; or
The current ABN on file is more than twelve (12) months old. In the event the ABN is more than twelve (12) months old an updated ABN must be signed in order to continue maintenance care. Once the new ABN is signed it shall be valid for twelve (12) more months or until another active treatment is initiated.

A Quick Refresher On Medicare’s Requirements For Self-Reporting & Returning Overpayments

By: Zach Simpson

With the current healthcare environment many providers looked to alternative methods of treating patients and achieving outcomes this past year due to the pandemic. To meet the needs of their patients, and their financial obligations many providers implemented services that were not customary to their practice, or their billing departments. As is the case for any office that begins to provide something new there is always the potential for error in any aspect of the practice involved with the patient or claim. Therefore, I believe it is a great time to refresh providers on the procedures for reporting and returning Medicare overpayments as they are discovered moving forward.

As many of you are aware in 2016 the Centers for Medicare and Medicaid Services (CMS) published a final rue pursuant to Section 1128J(d) of the Social Security Act (the Act), as amended by the Affordable Care Act, that requires Medicare Parts A and B health care providers to report and return overpayments 60 days after the date an overpayment is identified, or the due date of any corresponding cost report, if applicable, whichever is later. If credible information indicates that an overpayment exists, the rule requires that a reasonably diligent inquiry must be performed.

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A Telehealth Break for Medicare Patients and Providers

new medicare laws for telehealth related to corona virus By: David J. Davidson

Up until now, Medicare has been fairly structured in how telehealth services are reimbursed. Medicare would pay for telehealth services only if certain, very narrow criteria were met. These rules covered the patient, the patient’s location, the provider, the types of services rendered, the telehealth equipment used and the way the services are coded. Those rules can now be relaxed under recent federal legislation.

On March 6, 2020, President Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act of 2020 into law. That law relaxes the current Medicare criteria, in order to expand the use of telehealth as a resource against COVID-19. Pursuant to this law, the Secretary of HHS has the authority to waive the “site” requirements for telehealth services provided to Medicare beneficiaries who are located in an identified “Emergency Area” during an “Emergency Period.” Since the whole country is currently is experiencing a public health emergency, as declared by both the President and the Secretary of HHS, the Emergency Period and Emergency Area requirements are met on a nation-wide basis.

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CERT Review and Top Five Medicare Documentation Errors

By: Matthew Fischer

In CMS’ latest “MLN Connects” newsletter, the agency discusses the Comprehensive Error Rate Testing (CERT) program and the top five documentation errors committed by providers. Providers should pay close attention when CMS releases these types of notices. If selected for CERT review, providers are subject to potential action such as post-payment denials, payment adjustments, or other actions depending on the results of the review. Therefore, providers should ensure they fully understand Medicare’s documentation requirements and how to meet these demands. Continue reading

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Can Physicians Limit the Number of #Medicare Patients They See?

42 C.F.R. 489.53 and Entitlement Manual Chapter 5 Eligibility limit Medicare patients Medicare General Information Medicare Part A Medicare provider Medicare State Operations Manual Section 10.2

Tag: Medicare provider

How Often Should Chiropractors Have Their Patients Sign A New Advance Beneficiary Notice (ABN)?

A Quick Refresher On Medicare’s Requirements For Self-Reporting & Returning Overpayments

A Telehealth Break for Medicare Patients and Providers

CERT Review and Top Five Medicare Documentation Errors

Can Physicians Limit the Number of #Medicare Patients They See?

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