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PS-101
Medicare Billing and How It’s Different

Go beyond the typical billing and collections procedures in order to be more successful as you work with your Medicare patients.

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This lesson directs doctors and team members through the special billing and collections processes associated with billing for Medicare patients. The Medicare systems require exact and specific methods for billing; this lesson goes beyond the typical billing and collections procedures in order to help you be more successful as you work with your Medicare patients.

  • Recognize the differences between billing and collecting for regular patients vs. Medicare patients
  • Explore the reasons DCs may not opt out of Medicare
  • Investigate the special billing instructions shared by the Medicare carrier (e.g., the proper use of Boxes 14 and 19 on the 1500 form)
  • Review Medicare’s Timely Filing rules
  • Create a policy for treating immediate family members following Medicare’s strict guidelines

Medicare Billing and How It's Different Implementation Guide

Fact Sheet:

  • Idiosyncrasies of the Code 97010
  • Billing Electrical Muscle Stimulation in Medicare
  • Medicare Timely Filing
  • Understanding Secondary or Supplemental Medicare Coverage
  • Crosswalk Rules for Medicare
  • Billing For Family Members With Medicare
  • Commonly Used Medicare Modifiers

Reference Tools:

  • Sample Medicare LCD Diagnosis List
  • 1500 Form Info Sheet
  • Helpful Sites for Medicare Billing

Rapid Tutorial:

  • What’s Really Different About Medicare Billing?

Self-Assessment:

  • The Medicare Billing Process

Sample Policy:

  • Treating Family Members with Medicare
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