Advanced Medical Billing Services Inc.

Annual PSA

IT’S OPEN ENROLLMENT FOR MEDICARE BENEFICIARIES-

Original Medicare is having Medicare Part A (hospital) and Part B ( professional. ) Be careful not to get mixed up with other plans that say they are “Medicare” but really are an entirely different medical plan that you have assigned your original Medicare benefits over to. It’s extremely important to know the difference. It could mean getting stuck with thousands of dollars in bills if you are not sure exactly what you are signing up for.

All inclusive Medicare advantage HMO plans- These plans are very appealing because they generally save you money on monthly premiums. The major difference is that you do not have original Medicare therefore, you cannot go and see any provider, specialist, or go to any clinic that you want. The freedom to take your insurance to any provider is gone. You now have a set group of providers that you must stay with and treatment must be prior authorized. This is a big difference because if you were ever in a position that you need a specialist, whether it be a cardiologist, and oncologist, a urologist, or an endocrinologist For example, you would have to go through the HMO protocol and see the provider they send you to instead of picking up the phone and calling the best provider in that specialty and making an appointment. If you are OK with that and understand what you are signing up for, then an HMO may be for you. 

Supplemental Insurance-
If you have original Medicare, you may want to purchase a supplemental insurance. Supplemental insurance plans cover the 20% coinsurance that Medicare does not pay. Some even cover the $233 annual Medicare deductible. I think a supplemental insurance policy is a good idea even if you just have one that covers you in case you were ever hospitalized. 

Many insurance reps do not really understand how the insurance actually works in the real world. Medicare is stand alone. Medicare part A (hospital) and Part B (professional).

I have done Medical billing for over 25 years and I have seen what happens when things get mixed up. Let me know if you have any questions.

Steven’s & Associates in Santa Barbara is a great place to get all of this straightened out. 805-683-3636. I have no association with them. I’m just trying to educate anyone that may need help in this area.

Happy Saturday

https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak

BLUE CROSS :

You may have already heard, but we wanted to let you know that Anthem Blue Cross (Anthem) will no longer offer many of our Affordable Care Act (ACA) individual health plans in California starting Jan.1, 2018. Until then, everything will stay the same.
What should I do if I have an individual ACA health plan?
If this affects you, you'll have plenty of time to prepare. You'll get a formal notice from us in the mail telling you that your plan is ending in 2018. As open enrollment gets closer, you can look at other plans so you can find new coverage. We'll help you connect with someone who can assist you in finding a new plan, even if it's not with Anthem. In the meantime, you can log into Anthem.com/ca to contact us or view the details of your current plan.
Why are you doing this?
Unfortunately, uncertainty in the health insurance market does not provide the clarity and confidence we need to offer affordable coverage to our members in 2018.

This is huge for all of the physicians and billing office in California.

Drug Screen billers:

If you bill for drug screen testing you may be getting frustrated like the rest of us. Medicare has admitted to a system error and will be reprocessing all of the claims they rejected in error.
As for the timeframe in the reprocessing they do not know.

Sounds like Medicare 😊