patient then can come back to have the test performed. Medicare Eligibility Scenario At the time of each visit, the registrar needs to check the patient’s Medicare eligibility. The registrar needs to perform four tasks to validate eligibility on the initial encounter and periodically during subsequent visits. Name the tasks and indicate one reason why each step is important. 1. Copy patients Medicare card: Check patient’s information and verify patient’s exact name, claim number, including numbers and letters, type of coverage. If the patient is coming to the office, make sure the patient has part B coverage. Check for effective dates. Verify the beneficiary number and make sure that the number is right when checking the eligibility information this is what Medicare recommends just in case the patient switched from classic Medicare to any advantage plans and perhaps we are not contracted with them. 2. Copy Driver License or ID: this is necessary to make sure the patient’s identity is valid. Make sure that the information on the patients Medicare card is the same as the ID or Driver license presented. Do this to avoid any fraud actions. 3. Obtain patients signature : to validate patient’s identity, this allows us to bill Medicare on their behalf. 4. Determine Primary and Secondary Payers: find out if the patient has any supplemental insurance or secondary insurance. As we know Medicare covers only 80% so we want to know who will be responsible for the remaining 20 % of the balance. Should we bill another insurance or will the patient be fully responsible for the last 20%.
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- Fall '18
- Allie Kotzian
- Centers for Medicare and Medicaid Services, Primary care physician, Magnetic resonance imaging, patient presents