Medicare Compliance & Reimbursement
Master ABNs with Noridian's New Tool
If filling out Medicare's Advance Beneficiary Notice of Noncoverage (ABN) form makes you break out in a sweat, you're not alone. New tools from CMS lead you step-by-step through the ABN form process. Reminder: If a service is deemed medically unnecessary, it may not be covered under Medicare. The ABN form, CMS-R-131, gives beneficiaries the information they need to determine whether or not to get the service or treatment. However, "if the beneficiary does not get written notice when it is required, he or she may not be held financially liable," reminds CMS guidance. "If Medicare denies payment, the provider or supplier may be financially liable if Medicare does not pay." CMS in coordination with MAC Noridian Healthcare Solutions, LLC offer a new website with an interactive tutorial to assist Medicare providers with ABNs. Resource: To access the ABN tutorial and online guidance, visit www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/ABN-Tutorial/formCMSR131tutorial111915f.html
Medicare Compliance & Reimbursement
- Reimbursement:
MedPac to Congress: MIPS Needs to Go
Most physician and hospital groups oppose the commission's drastic suggestions. Medicare providers are rounding the [...] - Medicare Policy:
Slow MIPS Down, Bipartisan Budget Act Suggests
Hint: Don't expect the Cost category percentages to go up anytime soon. The first year [...] - Billing:
Avoid Denials with This LT and Reciprocal Billing Primer
Tip: Manage modifiers correctly to ensure clean claims. Medicare providers work hard day in and [...] - Review These LT and Reciprocal Billing Key Points
Watch the NPI rules. Doctors go on vacations, have family emergencies, and get sick just [...] - Revenue Booster:
Make Light Work of Bundling Edits with This CCI Advice
Tip: Familiarize yourself with private payer policies to ensure steady pay. It's no secret that [...] - HIPAA:
Put HIPAA Training at the Top of Your Spring To-Do List
Tip: Auxiliary staff need to feel safe to report violations. As HIPAA breaches rise in [...] - Industry Note:
Master ABNs with Noridian's New Tool
If filling out Medicare's Advance Beneficiary Notice of Noncoverage (ABN) form makes you break out [...] - Industry Note:
Azar Nominates HIV Expert to CDC Post
Last week, HHS Secretary Alex Azar named clinical researcher and HIV-expert Dr. Robert R. Redfield [...] - Industry Note:
MD Gets 3 Years in Jail and $3 Million in Restitution for PT Scam
As the feds continue to turn up the heat on Medicare fraudsters, more serious indictments [...]
