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November 4, 2022 in
What are Advance Beneficiary Notices?
Medicare covers medically necessary services and certain preventive services. Please visit medicare.gov for specific benefit coverage information. Advance Beneficiary Notice (ABN), is used to inform you that Medicare may not cover a service because it does not meet their definition of medically necessary. The purpose of the form is to help you make an informed decision. Because Medicare is unlikely to pay for the service does not mean that you should not receive it. There may be a good reason...
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November 4, 2022 in
Will my service or visit be covered by Medicare?
Medicare covers medically necessary services and some preventive services. The preventive services coverage is often dependent on the frequency of the service. For specific benefit information, please refer to Medicare.gov....
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November 4, 2022 in
Will I have to pay any money for my hospital visits?
Yes. As a Medicare patient, you will be responsible for non-covered charges, co-pays and deductible amounts. These amounts may vary depending on your Medicare coverage. We do not know what your payment may be until we receive the notification from Medicare. Once Medicare lets us know your responsibility, we will bill any other health insurance for the balance. If you do not have other health insurance, you will receive a bill for the balance....
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November 4, 2022 in
Should I pay the balance that is listed on “your total responsibility” on the Medicare Explanation of Benefits form?
No. This amount may change depending on your individual insurance coverage. Please wait until you receive a bill from us before making payment....
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November 4, 2022 in
What is the difference between Part A and Part B Medicare Explanation of Benefits forms?
Part A covers inpatient hospitalization and Part B covers outpatient and provider services....
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November 4, 2022 in
What is a Medicare Explanation of Benefits form?
The Explanation of Benefits (EOB) form is a document that Medicare sends to you after it has processed your medical claims. The EOB form provides you with information about the payment status of your bill. We recommend you keep the Explanation of Benefits forms you receive from Medicare until your medical claims have been paid in full....
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November 4, 2022 in
Do I have to sign any forms before RMC can bill Medicare?
Yes. Medicare requires that we ask a series of questions to determine the insurance with primary responsibility for the claim at each visit. You will need to sign the Consent for Treatment form each time you receive services....
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November 4, 2022 in
I have health insurance in addition to Medicare coverage. Will you bill that insurance company also?
Yes. If you have given us information about your additional health insurance, we will bill that insurance company after Medicare has made their payment....
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November 4, 2022 in
Why do I have to give you information about other insurance if I have Medicare coverage?
We need information about all of your insurance coverage. Medicare requires us to bill any insurance company that may be responsible before we bill Medicare. We cannot file claims until your other insurance company has determined what they are responsible for paying. If you enrolled in a Medicare Advantage plan, that plan is responsible for your medical claims. Medicare Advantage Plans are not the same as Medigap plans or Medicare Supplements. Some Medicare Advantage Plans have provider networks and may...
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November 4, 2022 in
Who can help me understand Medicare better?
Senior Health Insurance Information Program (SHIIP) is a FREE service that helps Medicare beneficiaries evaluate and better understand their coverage options....
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November 4, 2022 in
Will my insurance pay for preventive services?
Contact your insurance company to check on your policy benefits for these types of services. Many insurance plans do cover preventive screening services at 100% with no cost to you. Please note that we are required to code and bill your medical claims compliantly. If you are actively seeking treatment or are on medication for a certain condition (i.e. high cholesterol), we cannot code services related to this condition as a screening service. We must code and bill your claims...
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November 4, 2022 in
What do I do if I disagree with how much my insurance company has paid on my bill?
Contact the insurance company and ask how your claim was processed. If the insurance company finds an error was made, write down the information you are given as well as the name of the person you spoke with at the insurance company. Request an anticipated payment date. If the bill does not get paid in the time frame they gave you, follow-up with the insurance company again. If the insurance company feels the bill was paid correctly and you still...
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