My understanding of outpatient Medicare claims where there is an OOP component is that the patient must have paid the account in full and the service must have already been rendered.
In a sit…
It is very common that doctors describe AMA fees as being “recommended fee”, but I wanted to check whether that was correct. I have recently heard it may not be.
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read more >I attended a workshop on Medicare billing and the presenter said that the words “To Which No Other Item Applies” – which we see on many items numbers (this was GP item numbers) – means you…
read more >I’ve been reading some of your material on social media and wanted to understand how it is possible that prisoners can access Medicare services while they are in prison. For as long as I can r…
read more >We operate a co-located private outpatient clinic on the grounds of a hospital complex. A patient who is an admitted patient in the hospital is referred by the treating doctor to come to our c…
read more >If an item number is paid for by DVA does it fall under the same compliance in regards documentation?
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read more >I did a telehealth consult on an admitted Bupa ADF patient in another state. The referral came from the Bupa ADF doctor who was with the patient (by his bedside) during my telehealth consult. …
read more >I was fascinated by your LinkedIn post that said the MBS is not the law. I (and I think the whole nation) always thought it was. How can the MBS and the law be different and what is the MBS th…
read more >At what precise moment in time does a non-admitted patient in the emergency department become admitted? Is it when the admitting doctor makes the decision to admit, or is it after the paperwor…
read more >This question has come from two almost identical experiences shared by physicians. The first was reported in my PhD and the second, which appears to have happened around the same time, was sha…
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