Independence: Annual Medicare Secondary Payer Group Size Collection Process

Ed MacConnell

Independence Blue Cross (Independence) is required to collect information from group customers with 300 or fewer employees regarding their employer size to ensure proper coordination of benefits and reporting under the Medicare Secondary Payer (MSP) laws. This information is used by The Centers for Medicare & Medicaid Services (CMS) to determine whether Independence or Medicare is the primary payer of claims for Medicare-eligible employees. We are mailing MSP notification letters this week to customers directing them to our MSP group size webpage, where they will find additional information on MSP and can complete a required survey. The survey must be completed by December 31. Customers will need their CID number (provided on the… Read More

Continue Reading

Medicare Advantage plans denying more inpatient claims

Ed MacConnell

MA plans have adopted more restrictive criteria commonly used by commercial health insurance carriers, found consulting firm Crowe. Medicare Advantage plans denying more inpatient claims MA plans have adopted more restrictive criteria commonly used by commercial health insurance carriers, found consulting firm Crowe Healthcare systems have found themselves in precarious financial standing due to a dramatic increase in the number of inpatient claims being denied by health insurers based on the lack of medical necessity, according to data collected by accounting and technology firm Crowe. These level-of-care reimbursement disputes are especially rising in frequency among Medicare Advantage plans. Read the full story by clicking the link below. https://www.healthcarefinancenews.com/news/medicare-advantage-plans-denying-more-inpatient-claims As always if you have any… Read More

Continue Reading

What is the Medicare Advantage Open Enrollment Period (OEP) and why is it important?

Ed MacConnell

The Medicare Advantage Open Enrollment Period (OEP) is different than the annual election period in the fall. The MA OEP happens annually from January 1st to March 31st. The OEP allows beneficiaries who are enrolled in a Medicare Advantage Plan to make a one-time change. Beneficiaries can use the Medicare OEP to: The Medicare OEP does not allow a beneficiary to change from one Part D plan to another Part D plan. The reason for the OEP is that Medicare beneficiaries are often confused about Medicare Advantage plans. They don’t understand how these plans work or they may not realize the plan has a network. Some Medicare beneficiaries try to make their… Read More

Continue Reading