Billing Medicare, TRICARE And Medicaid
The Billing Medicare, Tricare and Medicaid course covers, in detail, insurance plans run by both federal and state governments. Medicare usually sets the standards for other insurance companies. This course will go into all four parts of Medicare (A, B, C & D) and explain requirements of Medicare billing. Also covered are the fundamentals of Medicaid insurance and TRICARE. While Medicaid is funded partially by the federal government it is run by the individual states. TRICARE covers those enrolled in the military and their families as well as retired military. Medicare participation, non-participation and opting-out are also explained. Government insurance plans such as Medicare, Tricare and Medicaid can be a little trickier than commercial insurance as there are different regulations. Medicare is extremely strict with the rules on submitting claims and the rules must be followed to insure proper payment. Fully understanding Medicare billing is extremely important in successfully submitting Medicare claims.
Topics Covered
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Medicare eligibility and enrollment
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The Medicare ID card and ID number
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Initial Enrollment Period
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Special enrollment period
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Premiums
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Deductibles and Copayment
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Medicare Part A
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Inpatient hospital benefits
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Skilled nursing care facility
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Hospice
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Continuous home care
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Respite care
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Medicare Part B
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Covered screening services
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Foreign travel
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Deductibles and co-insurance
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Assignment
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Participation and non-participation
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Limiting charge
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Clinical laboratory tests
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Ambulance service
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Hospital emergency room
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HPSA – Health Professional Shortage Areas
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Telehealth
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Medicare secondary payer
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Private contracts with providers
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Medigap
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Medicare Advantage Plans
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Medical Savings Account
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Private fee for service plans
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Medicare for people who are working
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Medicare and COBRA
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Medicaid
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History of Medicaid
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Requirements to receive federal funding for Medicaid
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Nursing facilities
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Covered outpatient drugs
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Medicaid fee for service
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Medicaid managed care
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Tricare
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History of Tricare
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Tricare Standard
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Tricare Prime
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US Family Health Plan
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Tricare Reserve Select
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Tricare Reserve Retired
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Tricare for Life
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Tricare Young Adult
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