tci Medicare Compliance & Reimbursement - 2017 Issue 22
Clip And Save: Know These Medicare Remittance Rules for Deductibles and Coinsurance
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Article Overview
This article reviews Medicare Part B billing practices for collecting patient cost-sharing amounts, with emphasis on remittance timing, payer verification, and how local MAC guidance can differ. It is aimed at billing staff, coders, and practice managers who handle patient collections and want to understand when deductibles or coinsurance may be addressed, how secondary insurance affects payment, and why some MACs advise caution. The discussion focuses on general compliance and workflow considerations rather than detailed coding or claim-edit instructions.
Why This Topic Matters
Understanding these Medicare remittance and collection practices can help practices reduce refunds, avoid payer issues, and align patient collection workflows with Medicare and MAC guidance.
What You Will Learn
- How Medicare Part B remittance timing relates to patient collection workflows
- Why payer verification matters before collecting patient cost-sharing amounts
- How secondary payer coverage can affect deductible collection practices
- How MAC guidance may differ on collecting deductible and coinsurance amounts
- What operational and compliance concerns practices consider when collecting at the visit
Who Should Read This
- Medical billers
- Coding professionals
- Practice managers
- Revenue cycle staff
- Healthcare compliance staff
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