MEDICARE
Medicare beneficiaries are identified by this number.
What is by their MBI number.
This type of equipment is intended for home use and intended for repeated use.
What is durable medical equipment.
Medicare provides clear coverage criteria in the form of these.
What is LCD or Local Coverage Determination
This type of Medicaid plan is run by a private insurance company under contract with the state.
What is Managed Care Organization or MCO.
The contractor that processes claims for Regions B and C are these initials.
What is CGS.
This common piece of equipment helps patients with sleep apnea breathe at night.
What is a CPAP machine.
This document from the doctor often supports medical necessity for DME
What is face to face notes.
Before billing a Medicaid MCO, suppliers must always verify this to avoid denials
What is eligibility or active plan coverage.
This is the number of months Medicare allows payments for capped rental items.
What is 13 months?
This form must be signed by the patient to prove delivery.
What is delivery ticket.
This document is often required for Medicare patients before certain DME items can be billed and proves the doctor is prescribing it.
What is a written order.
Submitting a claim to the wrong MCO will result in this.
What is denial.
CMN status is helpful in determining this -
What is same/similar items billed.
This is the term for equipment rented to the patient over several months instead of being purchased.
What is capped rental.
The majority of denials are caused by mistakes during which process?
What is intake.
Unlike traditional Medicaid, MCO plans require you to follow their own set of these.
The type of insurance plan administered by commercial payers that handles benefits for Medicare patients is known as this.
Medicare Advantage Plan
This is the name of the product line that includes walkers, commodes, etc.
What is bent metal.
Suppliers can guarantee audit proof claims by making sure they have what on file?
What is all necessary documentation.
Some items aren’t covered by the MCO, but paid by the state Medicaid program. These are called what?