Parts of Medicare
What part of Medicare covers inpatient hospital stays?
Part A
Age requirement for medicare
65
What two pieces of information is required for HIPAA verification?
First and Last name and DOB
What does INN stand for?
In Network
What does NPS stand for?
Net Promoter Score
What part of Medicare covers Outpatient services?
Part B
What is ESRD
End Stage Rental Disease
What are three optional pieces of information to HIPAA verify but required to be apart of verification?
Full address, Member ID, and Medicare ID
What does Non-Par stand for?
Non participating.
What is a NPS score of 0-6 called?
Detractor
What part of Medicare covers prescriptions?
Part D
How long have to be on disability to qualify for Medicare?
2 or more years
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
What are examples of providers?
Physician, Physician groups, Facility and Other
What is the score of 7-8 called?
Passive
What part combines Part A and B and sometimes includes Part D?
Part C or Medicare Advantage plan
What is the time frame surrounding a persons 65th birthday to enroll in medicare?
3 months before, month of birthday, and 3 months after
When was HIPAA established?
August 21, 1996
What is an example of Other providers?
Pharmacist, DME providers
What is a score of 9-10 called?
Promoter
What is original Medicare?
Parts A and B
What parts of medicare must you have to be eligible to enroll in Part D?
Have to have A and B to enroll in Part D
What must we do before we HIPAA verify?
Three part start. Ask, Acknowledge and Reassure
What is balance billing and who can balance billing?
When a doctor charges for expenses not covered by medicare to get full amount for bill. NON PAR providers can balance bill
How do you calculate NPS percentage?
Take the number of promoters and divide by number of detractors.