Understanding Medicare & Medicaid for Dually Eligible Beneficiaries Dually eligible beneficiaries are individuals who qualify for both Medicare and Medicaid, making them eligible for a broad range of healthcare services. These beneficiaries typically have limited income and resources, qualifying them for additional support to cover healthcare costs that Medicare does not fully pay. Here’s a
Understanding Transitional Care Management (TCM) Services: A Comprehensive Guide Transitional Care Management (TCM) services play a crucial role in ensuring that patients who are discharged from inpatient care facilities receive the appropriate follow-up care necessary to transition smoothly back into their community settings. These services are vital for preventing readmissions, improving patient outcomes, and managing
Understanding the Skilled Nursing Facility (SNF) 3-Day Rule for Medicare Billing Navigating Medicare’s billing requirements can be complex, especially when it comes to the Skilled Nursing Facility (SNF) 3-Day Rule. This rule is critical for ensuring that Medicare covers SNF services, and understanding it can help prevent denied claims and unexpected costs for patients. Here’s
Reimbursement Changes Medicare Reimbursement Rate Adjustments: Background: Medicare periodically adjusts reimbursement rates for DME based on market data and competitive bidding outcomes. Recent Changes: Rates have been adjusted to reflect the savings achieved through competitive bidding, with reductions in payment rates for many items. Impact: Lower reimbursement rates can challenge the profitability of DME
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