All Things Medicare! (Bundle of Billing Help + Rules)

$140.00

Four hours of All Things Medicare! Get Medicare Billing Help! and Master the Medicare Rule Book! together in one download, at a special discounted price!

It may sound intimidating – but don’t watch it all in one go. Keep it as a resource, or take it 1 topic at a time (more manageable that way…)

The goal here is for you to improve your confidence in dealing with Medicare, and to learn about the many resources out there that can offer further help, as needed.

Version Date: June 2024

Before you groan at the thought of four hours of All Things Medicare…remember that this download is yours to keep. It isn’t meant for memorization. There are no tests. You don’t have watch for four hours straight or remember Every Little Thing. Instead, it’s the best place to look for real-life answers to the most common questions about All Things Medicare – when you need to – without tearing your hair out trying to decipher documents on CMS’s website or on your local Medicare contractor website.

Medicare Billing Help!

  • Parts of Medicare
  • Verifying eligibility: how do you do it? how do you interpret it?
  • Determining whether your client really has Medicare Advantage (MA)
  • What is Railroad Medicare?
  • Weird statuses and acronyms: MSP, QMB, Dual-eligible…say what?
  • Medicare benefits
  • Billing the next payer – I have good news for you here!
  • Differences between secondary and supplemental plans
  • How to tell at a glance what a supplemental plan will cover! Yes…it really can be done!
  • Setting up your billing system for Medicare
  • Electronic data interchange (EDI) enrollment
  • Common billing errors and how to avoid them
  • What is that darn sequester thing?
  • How do I know how much to collect from my client?
  • Can’t I just hand them a superbill?
  • How to read the Medicare standard paper remittance (EOB). What do all those codes mean?
  • Should you enroll with your Medicare Administrative Contractor’s portal?
  • If you have a problem, what now? Reopenings & redeterminations.

Distinguish between Original Medicare and Medicare “Advantage”

  • What happens when you’re out of network with Advantage?
  • Can you see an Advantage client self-pay?
  • Do you want to be in-network with Advantage?
  • Benefits under Medicare Advantage
  • Fees paid by Medicare Advantage
  • What does Medicare Advantage pay? How is it different from Original Medicare?
  • Interacting with MA payers. What’s your recourse if you run into problems?

Master the Medicare Rule Book!

  • Telehealth: what’s covered?
  • How to code for telehealth in 2024
  • Do you need to see people in person?
  • What’s covered under Medicare?
  • How to find out what’s covered using Local Coverage Determinations / Articles
  • National Coverage Determinations/Articles
  • Brief look at documentation & audits
  • Will Medicare cover supervisees/associates/interns?
  • The truth about incident-to billing
  • What if I need to make a change to my provider enrollment?
  • What is Do Not Forward and what do I need to look for?
  • What are the new provider enrollment rules in 2024 and how do they affect me?
  • What is the CMS Regional Office and when should I contact them?
  • Resources for help: Medicare Administrative Contractors, MLN subscriptions, and more!

An in-depth dive into All Things Medicare Advantage:

  • Contracting with Advantage plans: IS it an advantage?
  • Can you be out of network with Advantage?
  • Benefits under Medicare Advantage
  • Fees paid by Medicare Advantage
  • What does Medicare Advantage pay? How is it different from Original Medicare?
  • Interacting with MA payers. What’s your recourse if you run into problems?
Correction to slide 50 in Medicare Billing Help! – The “timely filing” deadline for reopenings is 1 year, not 120 days.
And for an update to telehealth coding as of July 2024, check out the 7/24/24 blog: Medicare telehealth coding flip-flop!