Frequently Asked Questions
Answer: No. Medicare Advantage Plans (MAP) are not supposed to reimburse patients for services by unenrolled providers even if the MAP offers out of network. That said, MAPs sometimes erroneously reimburse patients. If your patient submits a claim and is reimbursed, that doesn’t necessarily mean it is ok. Medicare patients should always go to Medicare […]
Non-compete agreements are increasingly viewed as non-competitive and many states are starting to prohibit them. The Federal Trade Commission (FTC) is expected to promulgate a final rule that will likely prohibit non-compete agreements in all 50 states in the near future. (See the FTC’s Proposed Rule at https://www.ftc.gov/legal-library/browse/federal-register-notices/non-compete-clause-rulemaking). Before inserting a non-compete clause in an
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Can a cash practice see a workers’ compensation patient? Maybe. State laws govern workers’ compensation. If your state laws allow the employee to choose their heath care providers, versus allowing the employer to direct what providers see their injured workers, then you should be able to see the patient. State work comp laws may
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Question: I need to work at another private practice to supplement my income while building my cash practice. The practice sees and bills Medicare under the practice’s NPI number. They will require me to enroll as a Medicare provider to treat their patients. Will this cause any issues for my cash practice? Will I have
Each state has a law about how long medical providers have to retain medical records. The time ranges between 5-10 years depending on the state. Some states require providers to maintain records longer if the patient is under 18. If you are a Medicare provider, you should keep patient records 10 years since Medicare can
Medical Record Retention Laws by State Read More »
Q: My patient has a Medicare Supplemental Insurance Plan. She wants to know if she can submit her claims to the supplemental insurance plan without submitting to Medicare first. Should I give her a statement to submit? A: Some supplemental plans may reimburse their insureds for medically necessary services provided by unenrolled providers without requiring
Can my patient submit a claim to their supplemental insurance plan? Read More »
Advice on Superbills When you agree to see a Medicare beneficiary who has elected to pay you cash instead of seeing a Medicare enrolled provider you are accepting some risk that the patient may try to submit your receipts to Medicare for reimbursement or to obtain a denial for a Medicare Supplemental Plan. If the patient
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Go Daddy Smart Line is a phone app that gives you a second line phone number so you can separate your business and personal texts and calls while carrying just one phone. Some providers are using this app for their business line, which raises the question – is it HIPAA compliant? Even though the app is
Go Daddy Smart Line – is it HIPAA Compliant? Read More »
If you are posting exercise on YouTube and are looking for a disclaimer to put on the page, try this: This video is not intended as medical or professional advice. Our YouTube exercise videos are provided for educational purposes only and are not intended to serve as medical or physical therapy advice to any individual. Any
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Do you need to know what the rules are for getting PT, OT and other services covered under Medicare, including what all the billing, coding and documentation rules are? The Medicare Benefit Policy Manual is where you need to look. PT, OT and Speech policies are in section 220 of Chapter 15, available here.
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