APPEALS AND DISPUTES:
appeal and dispute processes.
BILLING CHRONIC CARE MANAGEMENT SERVICES:
bill for the new Chronic Care Management code 99490.
BILLING FOR DUAL -
Billing Qualified Medicare Beneficiaries (QMB), also known
as dual eligible, is prohibited by CMS. Federal law protects QMBs from any
cost-sharing liability and prohibits all original Medicare and Medicare
Advantage providers - even those who do not accept Medicaid - from billing these
patients their Medicare deductibles, coinsurance, or copayments. All Medicare
and Medicaid payments that physicians receive for furnishing services to a QMB
individual are considered payment in full. For additional information, see MLN Matters, Prohibition on Balance
Billing Dually Eligible Individuals Enrolled in the Qualified Medicare
Beneficiary (QMB) Program.
INTERPRETATION SERVICES FOR THE HEARING IMPAIRED:
will pay for sign language services when specified criteria is met.
PAYMENT ASSISTANCE PROGRAM:
Harris County Medical Society (HCMS) offers a payment assistance program to our
members to assist them with payment issues.
on billing for physician extenders.
PROMPT PAY DISCOUNTS
on offering prompt pay discounts to patients.
and information regarding recoupments.
TEXAS PROMPT PAY- (Fully Insured
June 17, 2003, Governor Perry signed into law SB 418 also known as Texas Prompt
Pay to help physicians receive payment for services promptly.
WHERE TO FILE COMPLAINTS
on filing complaints against Medicare, Medicaid, and other governmental payers.