Is Your Patient in a Managed Care Plan?

It is extremely important that you question your patient about their Medicare coverage each time they arrive at your office for an appointment. It is important to ask them what kind of coverage they have so you can be assured that you will send their claim to the correct entity. A patient who has chosen to enroll in a Medicare Managed Care Plan will have an additional card from that plan.

Most of the denials we see from Medicare is patient is enrolled in an HMO. I cannot stress the importance of getting correct billing information before submitting your charges. If not, the claims are billed only to be denied for patient enrolled in HMO. Then we have to find out what the correct insurance is then rebill it. This causes your revenue not to flow as fast as it should and if your billing is done in house it cost you more money.


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