Flashcards in Overview Deck (30):
acute, active, restorative, arrest of progression, corrective care
maitentenance, ABN signed, patient know medicare won't pay, can collect from patient
you forgot to present the ABN to the patient, ABN was not signed, cannot collect from patient, medicare won't pay
statutorily exluded service
patient knowns medicare won't pay, can collect from patient
statutorily excluded service
ABN voluntarily signed
can collect from patient
amount patient has to pay per month
set dollar amount due the day the patient is seen
% patient is responsible for
set dollar amount patient has to pay before insurance will kick in
explanation of benefits/remittance advice
provider calls insurance company to see what the insurance covered
docor explains the benefits patient can receive
center for medicare and medicaid services
office of inspector general
looks for fraud
need one to enroll in medicare
medicare administrative center
day to day claim processing
validates the reason we saw and are treating the patient
enrollment in medicare
gone through online process
can be PAR or non-PAR
frequency of visits
next date for evaluation
duration of treatment plan
deals with medical equipment and supplies
diagnosis codes for patients
who can see medicare patients
people who have NPI
what part of medicare covers chiropractic care?
part B and C
what is needed to prove medical necessity?
documentation has to line up with diagnosis codes and procedure and linked with pointer
how can you be eligible for medicare
65 or older
what services will medicare pay for?
what order should you diagnose for medicare patietns?
1. subluxation (M99...)
how old can a date of onset be before medicare considers it maitenance?
where do the OIG find problems in records of chiropractors?
validating medical necessity
date of onset isn't the same day they saw the patient