Author Topic: Medicare question  (Read 1738 times)

EC

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Medicare question
« on: May 07, 2010, 09:36:31 PM »
Hi could some one help, I am confused on when to bill medicare. Correct me please.....

A patient insured with AARP medicare complete and medicare part A, part B.  I will bill AARP as primary insurance and mark No on cms1500 11d?
A patient insured with Empire blue and medicare part A. I will bill Empire and mark No on cms1500 11d?
A patient insured with Oxford insurance and medicare part A and part B. I will bill medicare and mark yes on cms1500 11d and oxford as other insurance?
A patient insured with United Health and medicare part A. I will bill United Health and mark No on cms 1500 11d?

thanks  ??? ??? ???

Pay_My_Claims

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Re: Medicare question
« Reply #1 on: May 08, 2010, 04:00:25 AM »
When you have a medicare replacement plan, you in a sense still have medicare, but the plan is being administered by the HMO/PFFS/PPO/Indemnity plan you are enrolled in. 

They don't have 2 insurances, so when you come across a situation where they give you the AARP Medicare complete card (or whatever they are enrolled in) and their Medicare card as well...don't think about "when you file the medicare", the Medicare is NO LONGER a part of the billing scenario


EC

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Re: Medicare question
« Reply #2 on: May 08, 2010, 10:34:25 PM »
   
Re: Medicare question
Reply #1 on: Today at 04:00:25 AM
Quote
When you have a medicare replacement plan, you in a sense still have medicare, but the plan is being administered by the HMO/PFFS/PPO/Indemnity plan you are enrolled in. 

They don't have 2 insurances, so when you come across a situation where they give you the AARP Medicare complete card (or whatever they are enrolled in) and their Medicare card as well...don't think about "when you file the medicare", the Medicare is NO LONGER a part of the billing scenario

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Thank You Charlene, really appreciated.
so, what scenario will I have to bill medicare as primary, could you give me an example ( I read from the book if a patient came in with two insurance: one is medicare and the other is commercial I always have to bill medicare first )?  medicare replacement plan is not supplement insurance? how do I differentiate if the insurance is medicare replacement?

Pay_My_Claims

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Re: Medicare question
« Reply #3 on: May 09, 2010, 01:05:42 AM »
when they have 2 insurances it depends on a variety of things. the type of plan (group, individual, supplement) so i can't just answer it

blhoffman

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Re: Medicare question
« Reply #4 on: May 09, 2010, 12:40:19 PM »
These links below should clear things up for you. The first link is a little long but detailed.    www.online-health-insurance.com: Medicare Primary or Secondary Health Insurance Coverage.       www.medicareinteractive.org: Medicare Interactive - when is Medicare the primary payer and when is it the secondary payer.

EC

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Re: Medicare question
« Reply #5 on: May 09, 2010, 10:04:57 PM »
Thank You very much Thank You  :D

blhoffman

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Re: Medicare question
« Reply #6 on: May 10, 2010, 08:15:14 AM »
Sorry, I did the research from my cell phone. The links did not take you right to the page. Here it is again with the direct link to the material.  :P

There are several pages of good information on this link. At the bottom you click next page.
http://www.online-health-insurance.com/health-insurance-resources/part3/page121.php


http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=317


Anand

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Re: Medicare question
« Reply #7 on: May 11, 2010, 01:44:38 AM »
Thanks for the link.

EC

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Re: Medicare question
« Reply #8 on: May 15, 2010, 09:32:21 PM »
Thank you very much