decisionhealth Newsletters, Answer Books - 2009 Issue 3 (March)
Medicare Overview / Part A and Part B
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Article Overview
This article explains the basic structure of Medicare and how its major parts differ, with particular focus on Parts A and B. It also describes general enrollment timing, common payment components, and the administrative roles involved in processing Medicare claims. The content is useful for readers who need a broad orientation to Medicare coverage categories, program funding, and the agencies and contractors that support claims administration.
Why This Topic Matters
A clear understanding of Medicare’s structure helps billing and coding professionals, office staff, and healthcare administrators identify which program component applies to a service and how Medicare administration is organized. This overview also provides context for anyone learning the basics of federal health coverage before moving into more detailed coding or reimbursement guidance.
What You Will Learn
- How Medicare is organized into multiple parts
- What kinds of services are generally associated with each Medicare part
- How Medicare coverage is funded at a broad level
- Basic enrollment timing for beneficiaries
- How CMS and its contractors fit into Medicare claims administration
Who Should Read This
- Medical coders
- Billing staff
- Healthcare administrators
- Practice managers
- Students learning Medicare basics
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