Long-Term Care

BALTC Q&A

Billing Alert for Long-Term Care, August 1, 2009

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When we get a new admission, we always verify whether Medicare or an HMO is the primary payer using the Medicare online system. Recently, we were sure a resident was covered under an HMO, so we billed accordingly, but the claim was denied.
After review, it was determined that Medicare was the primary payer and the insurance we billed was really the secondary insurance carrier. Now we are worried that we are not reading the Medicare online system information properly. What can we do to be sure we don’t make this mistake again?

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to Billing Alert for Long-Term Care.

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