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5600Re: Medicare denials

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  • Melinda
    Sep 6, 2011
    • 0 Attachment
      It depends on the patient's supplemental plan. Some do. If Medicare doesn't pay (for example 99397), then the supplement might not pay, as Medicare didn't pay. You'd have to check on the patient's indiv. benefits to discover.

      Melinda Brown, CMBS
      Ins Biller

      --- In MedicalBillers@yahoogroups.com, Halbert <halberts1@...> wrote:
      >
      > If the patients have Medicare primary and then a secondary like AARP or BCBS will the secondary still pay for the G codes??
      >
      >
      >
      > ________________________________
      > From: Melinda <melindadocsmith@...>
      > To: MedicalBillers@yahoogroups.com
      > Sent: Tuesday, August 30, 2011 2:10 PM
      > Subject: [MedicalBillers] Re: Medicare denials
      >
      >
      >  
      > In addition to what was already said...
      >
      > Medicare does pay for the IPPE (Welcome to Medicare) - G0402 and now pays for the AWV (see below)
      >
      > Annual Wellness Visit (AWV) - This is a new benefit beginning for dates of service on and after 01/01/11
      >
      > G0438 â€" First visit
      > G0439 â€" Subsequent visit
      >
      > No specific diagnosis code
      > Contact the local Medicare Contractor for guidance
      >
      > Who is covered: All Medicare beneficiaries who are no longer within 12 months after the effective date of their first Medicare Part B coverage period and who have not received an IPPE or AWV within the past 12 months
      >
      > Frequency: Once in a lifetime for G0438, Annually for G0439
      >
      > Beneficiary pays:
      > Prior to 01/01/11: N/A
      > On or after 01/01/11: Copayment/coinsurance waived, Deductible waived
      >
      > http://www.cms.gov/MLNProducts/downloads/MPS_QuickReferenceChart_1.pdf
      >
      > Melinda Brown, CMBS
      > Ins Biller
      >
      > --- In MedicalBillers@yahoogroups.com, Halbert <halberts1@> wrote:
      > >
      > > Ok so Medicare and I aren't friends apparently. I'm getting alot of them back with Non-Covered Charges.  I billed for Preventative 99387 with V70.0. Where am I going wrong???
      > >
      > > Thanks
      > > Christy
      > >
      > >
      > > [Non-text portions of this message have been removed]
      > >
      >
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      >
      > [Non-text portions of this message have been removed]
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