Medicare Replacement Policies

Here are the most common plans that have replaced Medicare policies:

Health Partners Freedom- these plans DO need to be prior auth.
Medica-Prime Solutions -PA as req by Medica
U-Care- Medicare Advantage
Blue Cross Blue Shield-Medicare Advantage

All these plans require medicare diagnosis and follow medicare guidelines (only adjustments covered/ no exams, therapies or x-rays) . These patients should still sign the ABN for these services.

Also, regarding the new fee slips: please make sure
Patient name is ledgible and that a date is being put on the top- if not by the patient, then by whoever is checking them in- this is our only signed record by the patient that they were in the office that day.

Thanks :)
Kathy S.

THEA KELLY

IF THEA KELLY CALLS FOR A MASSAGE APPT, PLEASE LET HER KNOW WE HAVE A 24 HR CANCELLATION POLICY. THIS WOULD BE THE 4TH APPT SHE WOULD MAKE WITHOUT SHOWING, SO WE NEED PAYMENT IN ADVANCE IN ORDER TO SCHEDULE AN APPT FOR HER.

Room Preference

For future reference - I would like to have all of my NP's start in room 1, even if I'm the only one in the office (Tues/Sat/etc). If that is not possible, I'll take what I can get, but that way I have my posters and personal info available for me and the patients to see. Thanks.

Collecting Sales Tax

Per our staff meeting on 1/14/08 regarding sales tax: According to the Minnesota Dept. of Revenue, we should be collecting sales tax of 6.5% on everything we sell here EXCEPT:
*Ace bandages
*Arch supports/insoles
*Braces of any kind
*Ice packs/ice bags
*Hot packs, heating pads

everything else gets taxed. If you would like a printed list of this, please see Kathy
thanks

ABN/Waiver

Hi all -

Every Medicare patient is required (by Federal Law) to sign an ABN (Advanced Beneficiary Notice). This form states that some services are not covered by Medicare and the patient has the option to receive those services or not (and be required to pay for said service). They need to read and sign this form. Since we have not been doing this, please do your best to have each Medicare patient sign one on their next visit. After that, we need to have each Medicare patient sign one at least every two weeks. If a patient's visits are more than two weeks apart, they will need to sign one EVERY VISIT.

Also, we will be implementing a waiver that is mostly geared to HSM and Blue Plus patients, due to their reqirement stating patients must be informed that if their insurance does not cover certain services, they (the patient) will be financially responsible. If a patient is not made aware of this prior to the service, they (the patient) can not be billed and we are forced to 'eat' that bill and adjust it off their account. I realize this may be a little confusing, but these are not our rules, we simply need to follow them.

Mike

supplements

When entering supplement charges in Medisoft, please use the VIT code. All supplements will be charged sales tax, regardless of how the amount written on the bottle/box was determined. Supplements will continue to be 15% off, and I will make sure that the info about "how to get 20% off" is available by the end of the week. You can use the SUPPLY code for any supports/supplies, which will also be taxed automatically. All you will need to do is enter the amount of the charge (after taking appropriate discount), tax will automatically be entered...

Mike

update to dec 11 post

as a correction to the december 11 post about auto/wc cases: these will now go in RED files so they can be distinguished from other files. any questions, please see kathy
thanks

family

We are now doing travel cards for family members.
Pam

New Charges

There are many new charges for the new year. Pay attention to the charge slip. (Example: Heat/Ice is now $20 not $16, Ifl is now $25 not $20).
Also, as of the first of the year Medicare patients will be responsible for the full amount of the
x-ray charge ($40/ xray)
Pam