Month: November 2012

Status Update: Where Each State Stands with Health Insurance Exchanges

The Affordable Care Act (ACA) requires each state to have a health insurance exchange through which low and moderate-income individuals can purchase private health coverage at subsidized rates. In line with the mandate that each individual have health insurance by 2014, the exchanges are likewise required to be fully operational in each state by January …

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CMS Final Rule: Increased Medicaid Payment Rates for Primary Care

Earlier this year, the Department of Health and Human Services announced its proposed rule to implement the Affordable Care Act provision that Medicaid reimburse primary care providers at the same rate as Medicare. On November 1, 2012, CMS issued a final rule to implement this increased payment for calendar years 2013 and 2014. Effective January …

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Good News for Maryland Medical Billers: Carefirst Accepts (Medicare) Electronic Secondary Claims

The news that so many local healthcare providers and Maryland medical billing companies have long awaited: Carefirst now allows for the electronic submission of Medicare secondary claims! This is a huge time and money saver when handling those secondary claims that did not automatically crossover from Medicare to Carefirst. This change actually became effective back …

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Is it OK for healthcare providers to routinely waive patient co-pays and co-insurance?

NO! While the practice of routinely waiving a patient’s co-pay or balance may seem like a harmless favor, it actually can be a violation of a provider’s contract with insurance companies. Several of our clients have asked us directly if it is OK to accept insurance payments and then make a courtesy adjustment on the …

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