Medicare is designed to provide health insurance coverage to people aged 65 or above. The national health insurance program of the US is divided into four parts – Part A – Hospital Insurance Part B – Medical Insurance Part C – Medicare Advantage Plan Part D Prescription Drug Coverage Healthcare providers across the country provide… Continue reading DO MEDICARE ADVANTAGE PLANS HAVE LIFETIME LIMITS?
Category: Blog
WHAT IS A RISK SHARING ARRANGEMENT IN A MANAGED CARE CONTRACT?
When a managed care organization gets ready to share an employer’s financial risk in case of unfavorable claim experience, then this mutual contract between employer and managed care is known as a risk-sharing agreement. This agreement needs a managed care organization to either share the risk of unfavorable medical claim experience of an employer or… Continue reading WHAT IS A RISK SHARING ARRANGEMENT IN A MANAGED CARE CONTRACT?
WHAT IS A LIFETIME CAP ON HEALTH INSURANCE?
It refers to the maximum dollar amount your insurer will pay for healthcare benefits during your lifetime or the duration you are enrolled. That is applicable to non-essential healthcare services. However, the ACA now prohibits annual dollar limits for healthcare policies under essential services. Since dental and vision care in healthcare plans come under the… Continue reading WHAT IS A LIFETIME CAP ON HEALTH INSURANCE?
ARE MEDICARE ADVANTAGE PLANS WORTH THE RISK?
Medicare Advantage plans are a bundle of Medicare Part A, Part B, and sometimes Part D, which provides all-in-one private medical insurance coverage. Medicare Part C or Medicare Advantage is the perfect alternative to original Medicare. In the United States, it’s estimated that one out of three people, 65 or above, enroll in Medicare Advantage… Continue reading ARE MEDICARE ADVANTAGE PLANS WORTH THE RISK?
HOW DO I FIND MY MEDICARE FEE SCHEDULE?
The Medicare fee schedule is a list of all the payments that Medicare pays to doctors and other healthcare providers/suppliers. On a fee-for-service basis, this comprehensive listing of fee maximums is utilized to reimburse a physician and/or other providers. Medicare typically covers 80% of the cost of covered services that are mentioned in the fee… Continue reading HOW DO I FIND MY MEDICARE FEE SCHEDULE?
HOW LONG DOES IT TAKE FOR MEDICARE TO PAY A PROVIDER?
Medicare system will render health care services to older citizens of the United States. It serves persons above the age of 65 years; as well as younger people suffering from end-stage renal disease; and any citizen regardless of age who is entitled to Social Security disability income beneficiaries. Medicare has four different parts addressing various… Continue reading HOW LONG DOES IT TAKE FOR MEDICARE TO PAY A PROVIDER?
WHAT DOES MEDICAID FFS STAND FOR?
Medicaid Fee for service (FFS) is the most convenient way of paying for healthcare services. This is a payment model which helps physicians to get reimbursement for their services provided to patients. The only setback of this payment system is that every time a patient visits the clinic, their insurance providers are billed for every… Continue reading WHAT DOES MEDICAID FFS STAND FOR?
DOES OBAMACARE ELIMINATE LIFETIME LIMITS?
Obamacare is also known as the “Patient Protection and Affordable Care Act (PPACA)”. It is an insurance plan that provides healthcare coverage to US citizens. Many health insurances may limit the individuals how much they spend on their insurance coverage each year or may set a “lifetime dollar limit”. If any patients spend more than… Continue reading DOES OBAMACARE ELIMINATE LIFETIME LIMITS?
DIFFERENCE BETWEEN WRITE OFF AND ADJUSTMENTS IN MEDICAL BILLING
What is a write-off? A write-off refers to an amount deducted by the provider from a medical bill and does not expect to collect payment owned by patients or payers. Write-offs are a common practice in the billing system. Primarily, write-offs can be bifurcated into two categories; approved and other write-offs. This depends upon the… Continue reading DIFFERENCE BETWEEN WRITE OFF AND ADJUSTMENTS IN MEDICAL BILLING
WHAT DOES CMS STAND FOR IN MEDICAL TERMS?
Centers for Medicare & Medicaid administers multiple government programs in health care for the public, under the authority of the U.S. Department of Health and Human Services. CMS operates Medicaid alongside Medicare as well as state and federal health insurance and supports CHIP (the Children’s Health Insurance Program). CMS also provides research reports, and data… Continue reading WHAT DOES CMS STAND FOR IN MEDICAL TERMS?
