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P.O. Box 4166, Huntington Beach, CA 92605


New Medicare Card – Transition begins April 1, 2018

On April 1, 2018, CMS will start mailing Medicare cards with new Medicare Beneficiary Identifiers (MBIs) to everyone with Medicare. The MBI will replace the Social Security Number (SSN)-based Health Insurance Claim Number for transactions like billing, eligibility status, and claim status after a transition period. You must be ready to accept the MBI beginning […]
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Medicare Part B Secondary Payer Deductible Issues

Medicare Part B claims processed after Friday, April 1, 2011, for which the beneficiary has a Medicare deductible remaining and Medicare is the secondary payer, are erroneously issuing payment despite the beneficiary’s deductible not being satisfied or despite the total Medicare Allowed Amount being applied towards the deductible. The recovery of overpayments made during this […]
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CMS Offers Web-based Enrollment in 15 States and District of Columbia

Physicians in 15 states (Delaware, Minnesota, New Jersey, Idaho, Missouri, North Carolina, Illinois, Nebraska, Pennsylvania, Iowa, Maryland, Tennessee, Kansas, Michigan, Wisconsin and the District of Columbia) can now use CMS web-based system, PECOS ( Provider Enrollment, Chain and Ownership System)  site to Apply for Medicare enrollment online display and update current enrollment data check application […]
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Ban on Faxed Prescriptions Deadline Moved

Much to the relief of Medicare doctors who rely on computer-generated faxes to send prescriptions to pharmacies, the banning of faxed prescriptions deadline has been moved to Jan. 1, 2012.  Without this delay, those physicians would have to go back to paper-based prescriptions. However, Medicare physicians should focused on CMS’ new e-prescribing program which allows […]
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More Palmetto GBA’s Bureaucracy

It is now 6 weeks into the transition and Palmetto’s Medicare CMS contract transition is still causing financial strain for thousands of clinics and providers.  So we thought it would be fun to track and share some of our own issues. Yes, Palmeto – you’re so special that we’ve created a whole section on our […]
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Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals

If you do any Medicare billing or are interested in becoming a Medicare provider, then you must download the new 10th edition of Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals that just came out this month. The guide is very thorough and include: Introduction to the Medicare Program […]
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Questions and answers on psychological and neuropsychological tests billed under CPT code range 96101-96125

1) Who is authorized by Medicare to bill for CPT code 96125 (that was added under CPT effective January 1, 2008)? CPT code 96125 ( standardized cognitive performance testing (eg, Ross Information Processing Assessment) per hour of a qualified health care professional’s time, both face-to-face time administering tests to the patient and time interpreting these […]
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