Medicare

2011-06-23T15:48:00.000-04:00

Medicare (CMS) Information

Did you know that your local Medicare contractor (carrier, fiscal intermediary, or Medicare Administrative Contractor (MAC)) is a valuable source of news and information regarding Medicare business in your specific practice location? Through their electronic mailing lists, your local contractor can quickly provide you with information pertinent to your geographic area, such as local coverage determinations, local provider education activities, etc. If you have not done so already, you should go to your local contractor website and sign up for their listserv or e-mailing list. Many contractors have links on their home page to take you to their registration page to subscribe to their listserv. If you do not see a link on the homepage, just search their site for “listserv” or “e-mail list” to find the registration page. If you do not know the Web address of your contractor’s homepage, it is available on the CMS website.

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Balance Billing Statues Florida

2011-05-01T15:01:00.001-04:00

While on the surface prohibitions on balance billing placed by various states sounds very supportive of consumers and helpful in stopping debt collectors, it usually only applies if you have HMO coverage. PPO coverage or indemnity plans won't be likely to fall under these state regulations. For example, this is published by the state of Florida:

A contracted or non-contracted Florida licensed medical provider or facility cannot bill a subscriber if the HMO fails to pay a claim for a covered service. Florida Law prohibits providers from billing members for covered services except for applicable co-payments, co-insurance or deductibles. The medical provider or facility may bill the subscriber for services received that are not covered by the HMO contract.

Florida Statute References:
HMO (Individual and Group): Statute 641.3154
Small Group Health:does not apply
Individual Health:does not apply
Large Group Health: does not apply
Out of State Group: does not apply
Standard & Basic (HMO & Insurance): Statute 641.3154

State of Florida Statutes

Claims Assistance Professionals

Medicare

Medicare (CMS) Information

Balance Billing Statues Florida