Do You Know the Dual Eligibility Rules?
Published December 15, 2009 | 
Medicare/Medicaid patients are not to have their cost-shares, co-insurances amount collected from them. That includes those patients who have only Medicare Part A and Medicaid or only Medicare Part B and Medicaid OR Medicare HMO/PPO/PFFS and some kind of Medicaid as well. If there is a Cost-share or copayment due by the patient the provider is to either accept the Medicare Insurance as payment in full or try billing the State Medicaid for the payment..
Additionally, we are not able to write the fee off as bad-debt as CMS (Centers for Medicare & Medicaid Services) does not reimburse providers for bad debt for uncollectible co-payments, coinsurance and deductibles of Medicare or Medicare Advantage Plan members. Looking at the CMS website for confirmation at: www.cms.hhs.gov/
In the Dual Eligible section I found some interesting information about that and pointers to other useful information as well. The websites lists the Dual Eligible Categories From Medicaid Only, Qualified Medicare Beneficiary (QMB), Specified Low-Income Medicare Beneficiary (SLMB), Qualifying Individual (QI) and finally Qualified Disabled and Working Individual (QDWI). There are only 2005 and 2006 Dual Eligible Income Limits on site and they have a link for the 2009 Poverty Guidelines put out by the Government every year: http://aspe.os.dhhs.gov/
poverty/09poverty.shtml
Updates to Bookstore
Published November 1, 2009 | For those who have visited our bookstore page you will find that we have updated the listings with 2010 books to use in your healthcare business. We looked for medical coding books including CPT codes, HCPCS codes and diagnosis codes as well. We have left the 2009 books because they are still valid. We have tried to locate as many reference materials for our readers to use as possible. You will find each of these books in the coding area and there are also reference books for those who do not code as well. The medical terminology books are very helpful to have around as well. There are even some reference cards specific to particular disciplines such as cardiology, obstetrics, orthodontics and more.
Summer Break & College Students
Published July 5, 2009 | For those of us who work in the Emergency Rooms in hospitals we have all experience the same thing. Kids in college and those who go on spring break in our area for some reason don’t know anything about their parents or the insurance that they are covered under. I mean you go off to college and are still covered under your parent’s insurance until you graduate. Great for you as you don’t have to pay for it. Young kids going on a school trip have a form that is filled out for them with their parents information and the insurance stuff. Please, please, please before you go off to college get the same information and keep it in your wallets! Most of you are over 18 and are supposed to be adults and should know the basics. For instance, you should know your parents full name, date of birth and where they work. If your parents don’t want to give you an insurance card then just make a copy of it front and back and write your parents information on the copy. That way when you have to be seen in an emergency room or urgent care center you can give them the copy, sign your forms and your bills will be paid. MAKE sure you get your copy back or better yet make several copies. (Keep those copies safe!…you don’t want your parents information floating around the commons.) You can download a copy by clicking here sample form .
Well, that was my rant for today. Be safe and come back again.
Posted in Emergency Room Registrations, General Info for Medical Office Clerks, Hospital Registrations, Medical Forms, Medical Insurance Coverage, Patient Registrations | 
college students need parents information, know your parents insurance information, students be prepared for medical visits | 
Leave a commentPatients Rights & Responsibilities
Published May 16, 2009 | Has your patients asked for a copy of the Patient Rights and Responsibilities? Have you read them? All states should have some version of these available on your state’s Health Department website. In Florida, we can get a free copy of them at the Florida Department of Health website and they are part of our Florida Statutes. Some of those rights include: The individual dignity of a patient must be respected at all times and upon all occasions; A patient in a health care facility has the right to know what patient support services are available in the facility; A patient has the right to receive a copy of an itemized bill upon request. A patient has a right to be given an explanation of charges upon request; andA patient has the right to treatment for any emergency medical condition that will deteriorate from failure to provide such treatment. Some of the responsibilities include: A patient is responsible for reporting unexpected changes in his or her condition to the health care provider; A patient is responsible for reporting to the health care provider whether he or she comprehends a contemplated course of action and what is expected of him or her; A patient is responsible for following the treatment plan recommended by the health care provider; and A patient is responsible for following health care facility rules and regulations affecting patient care and conduct.
So, take a look at this brochure, if it is available at your medical facility. If you do not have them already printed up you probably should have them displayed as most if not all states have regulations about such things. If nothing else you can copy and print them from your state’s Health Department and have them available.