Medicare Truths
7 views | +0 today
Follow
Medicare Truths
Most people do not know how Medicare will work the best for them or when to apply for benefits. We teach businesses and individuals how to get the most effective use out of Medicare and related government programs (Medicaid, Social Security, ACA) to properly prepare for retirement.
Curated by Toni King
Your new post is loading...
Your new post is loading...
Rescooped by Toni King from Insurance News
Scoop.it!

CMS wants to overhaul Medicare broker comp | LifeHealthPro

CMS wants to overhaul Medicare broker comp | LifeHealthPro | Medicare Truths | Scoop.it
The agency wants to cap commissions, and it might limit referral fees to $100.

Via Mike Gattorna
more...
No comment yet.
Rescooped by Toni King from Heart and Vascular Health
Scoop.it!

How to Appeal Denied Medicare Claims

How to Appeal Denied Medicare Claims | Medicare Truths | Scoop.it

There are several things Medicare beneficiaries can do to reduce their costs. One of the most prominent started last week: the annual open-enrollment period (which runs through Dec. 7), where people can add, drop or switch medical and prescription-drug plans.

But an equally important strategy—and one that most beneficiaries don't pursue—is appealing denied medical claims.

Appeals of denied claims have high success rates. Here are the steps you need to follow.


Via Seth Bilazarian, MD
more...
No comment yet.
Rescooped by Toni King from Insurance News
Scoop.it!

Myth vs. Fact: Administrative Costs in Medicare ... - AHIP Coverage

It's a familiar refrain, one we've blogged about multiple times - comparing Medicare's administrative costs to those of private health plans is inaccurate. As Avik Roy noted in a blog post, “A more accurate measure of overhead ...

Via Mike Gattorna
more...
No comment yet.
Rescooped by Toni King from Rockstar Research
Scoop.it!

Medicare Will Not Pay For Hospital Mistakes And Infections, New Rule

Medicare Will Not Pay For Hospital Mistakes And Infections, New Rule | Medicare Truths | Scoop.it

Via Louie Helm
more...
Louie Helm's curator insight, November 25, 2013 2:14 AM

Medical Breakthrough: 100,000 patients a year were dying from hospital acquired infections. Then in 2008, infection rates started plummeting. What brought about the improvement? Technical innovation? Academic studies? New drugs? Better procedures? Improved training? Checklists?


Nope. Hospital acquired infection declined as soon as the US government stopped purchasing them. For 40 years, Medicare and Medicaid paid hospitals for their most harmful mistakes -- including causing hospital acquired infections, giving people bedsores, and leaving objects inside patients during surgery.


Then in 2005, a couple MBAs noticed the poor incentive structure. They pointed out that the government was spending $25 billion/yr (out of their $600 billion budget) on healthcare for "secondary diagnoses" -- conditions that patients only contracted because they were unfortunate enough to be admitted to US hospitals.


Finally in 2007, the government announced it would no longer pay hospitals for infecting or injuring their patients. Since then, hospital acquired infection rates have been in free fall.


So what actually happened? Studies show that hospital workers began washing their hands again -- up to a full 30% of the time! But no amount of abstract knowledge could motivate doctors to stop injuring 1 in every 20 patients until there was no longer a government billing code for "failure".

Scooped by Toni King
Scoop.it!

How Medicare covers Alzheimer's disease - Bradenton Herald

How Medicare covers Alzheimer's disease - Bradenton Herald | Medicare Truths | Scoop.it
How Medicare covers Alzheimer's disease
Bradenton Herald
Q: What all does Medicare cover when it comes to Alzheimer's disease? My wife was recently diagnosed with early stage Alzheimer's and I would like to find out what's covered and what's not.
more...
No comment yet.
Scooped by Toni King
Scoop.it!

Sorry Grandma…you weren’t “Formally Admitted” and You Owe a $36,000 Skilled Nursing Stay!! » Toni Says | Toni Says

Sorry Grandma…you weren’t “Formally Admitted” and You Owe a $36,000 Skilled Nursing Stay!! » Toni Says | Toni Says | Medicare Truths | Scoop.it
Toni, You wrote an article a few years ago that addressed the length of time you had to spend at a hospital before Medicare would pay for a skilled
more...
No comment yet.
Rescooped by Toni King from Rockstar Research
Scoop.it!

Medicare Will Not Pay For Hospital Mistakes And Infections, New Rule

Medicare Will Not Pay For Hospital Mistakes And Infections, New Rule | Medicare Truths | Scoop.it

Via Louie Helm
more...
Louie Helm's curator insight, November 25, 2013 2:14 AM

Medical Breakthrough: 100,000 patients a year were dying from hospital acquired infections. Then in 2008, infection rates started plummeting. What brought about the improvement? Technical innovation? Academic studies? New drugs? Better procedures? Improved training? Checklists?


Nope. Hospital acquired infection declined as soon as the US government stopped purchasing them. For 40 years, Medicare and Medicaid paid hospitals for their most harmful mistakes -- including causing hospital acquired infections, giving people bedsores, and leaving objects inside patients during surgery.


Then in 2005, a couple MBAs noticed the poor incentive structure. They pointed out that the government was spending $25 billion/yr (out of their $600 billion budget) on healthcare for "secondary diagnoses" -- conditions that patients only contracted because they were unfortunate enough to be admitted to US hospitals.


Finally in 2007, the government announced it would no longer pay hospitals for infecting or injuring their patients. Since then, hospital acquired infection rates have been in free fall.


So what actually happened? Studies show that hospital workers began washing their hands again -- up to a full 30% of the time! But no amount of abstract knowledge could motivate doctors to stop injuring 1 in every 20 patients until there was no longer a government billing code for "failure".

Rescooped by Toni King from Glossarissimo!
Scoop.it!

(EN) (ES) - Medicare Glossary | Medicare.gov

(EN) (ES) - Medicare Glossary | Medicare.gov | Medicare Truths | Scoop.it

"This glossary explains terms in the Medicare program."


Via Stefano KaliFire
more...
Rescooped by Toni King from Glossarissimo!
Scoop.it!

(EN) (ES) - Medicare Glossary | Medicare.gov

(EN) (ES) - Medicare Glossary | Medicare.gov | Medicare Truths | Scoop.it

"This glossary explains terms in the Medicare program."


Via Stefano KaliFire
more...
Scooped by Toni King
Scoop.it!

Medicare to Cover More Mental Health Costs - NYTimes.com

Medicare to Cover More Mental Health Costs - NYTimes.com | Medicare Truths | Scoop.it
Effective Jan. 1, Medicare will cover the costs of mental health care much as it does other medical expenses.
more...
No comment yet.
Scooped by Toni King
Scoop.it!

Medicare claim denial process begins Jan. 6 - American Dental ...

Washington—The Centers for Medicare & Medicaid Services will instruct contractors to turn on Phase 2 denial edits for claims from health care providers for particular Medicare-covered items or services for Medicare ...
more...
No comment yet.