Advanced Medical Billing Services Inc.

08/30/2024

It’s almost that time again

PSA for all our seniors and Medicare eligible people

Annual PSA

IT’S OPEN ENROLLMENT FOR MEDICARE BENEFICIARIES-

Original Medicare is having Medicare Part A (hospital) and Part B ( professional. ) Be careful not to get mixed up with other plans that say they are “Medicare” but really are an entirely different medical plan that you have assigned your original Medicare benefits over to. It’s extremely important to know the difference. It could mean getting stuck with thousands of dollars in bills if you are not sure exactly what you are signing up for.

All inclusive Medicare advantage HMO plans- These plans are very appealing because they generally save you money on monthly premiums. The major difference is that you do not have original Medicare therefore, you cannot go and see any provider, specialist, or go to any clinic that you want. The freedom to take your insurance to any provider is gone. You now have a set group of providers that you must stay with and treatment must be prior authorized. This is a big difference because if you were ever in a position that you need a specialist, whether it be a cardiologist, and oncologist, a urologist, or an endocrinologist For example, you would have to go through the HMO protocol and see the provider they send you to instead of picking up the phone and calling the best provider in that specialty and making an appointment. If you are OK with that and understand what you are signing up for, then an HMO may be for you. 

Supplemental Insurance-
If you have original Medicare, you may want to purchase a supplemental insurance. Supplemental insurance plans cover the 20% coinsurance that Medicare does not pay. Some even cover the $240 annual Medicare deductible. I think a supplemental insurance policy is a good idea even if you just have one that covers you in case you were ever hospitalized. 

Many insurance reps do not really understand how the insurance actually works in the real world. Medicare is stand alone. Medicare part A (hospital) and Part B (professional).

I have done Medical billing for over 25 years and I have seen what happens when things get mixed up.

Let me know if you have a questions. i’m happy to answer any questions I can about this. I’m rather passionate about making sure that everyone understands what they are enrolling in and how it will work with their medical providers. 

Happy Friday

10/29/2022

Annual PSA

IT’S OPEN ENROLLMENT FOR MEDICARE BENEFICIARIES-

Original Medicare is having Medicare Part A (hospital) and Part B ( professional. ) Be careful not to get mixed up with other plans that say they are “Medicare” but really are an entirely different medical plan that you have assigned your original Medicare benefits over to. It’s extremely important to know the difference. It could mean getting stuck with thousands of dollars in bills if you are not sure exactly what you are signing up for.

All inclusive Medicare advantage HMO plans- These plans are very appealing because they generally save you money on monthly premiums. The major difference is that you do not have original Medicare therefore, you cannot go and see any provider, specialist, or go to any clinic that you want. The freedom to take your insurance to any provider is gone. You now have a set group of providers that you must stay with and treatment must be prior authorized. This is a big difference because if you were ever in a position that you need a specialist, whether it be a cardiologist, and oncologist, a urologist, or an endocrinologist For example, you would have to go through the HMO protocol and see the provider they send you to instead of picking up the phone and calling the best provider in that specialty and making an appointment. If you are OK with that and understand what you are signing up for, then an HMO may be for you. 

Supplemental Insurance-
If you have original Medicare, you may want to purchase a supplemental insurance. Supplemental insurance plans cover the 20% coinsurance that Medicare does not pay. Some even cover the $233 annual Medicare deductible. I think a supplemental insurance policy is a good idea even if you just have one that covers you in case you were ever hospitalized. 

Many insurance reps do not really understand how the insurance actually works in the real world. Medicare is stand alone. Medicare part A (hospital) and Part B (professional).

I have done Medical billing for over 25 years and I have seen what happens when things get mixed up. Let me know if you have any questions.

Steven’s & Associates in Santa Barbara is a great place to get all of this straightened out. 805-683-3636. I have no association with them. I’m just trying to educate anyone that may need help in this area.

Happy Saturday

03/17/2020

https://www.cms.gov/newsroom/press-releases/president-trump-expands-telehealth-benefits-medicare-beneficiaries-during-covid-19-outbreak

03/13/2020

https://www.aafp.org/journals/fpm/blogs/gettingpaid/entry/coronavirus_testing_telehealth.html

CMS has loosened restrictions on telehealth reimbursement for areas where the spread of the new coronavirus has been deemed an emergency.

06/09/2019

https://www.fiercehealthcare.com/payer/anthem-to-acquire-behavioral-health-provider-beacon-health-options?mkt_tok=eyJpIjoiTVRNMllXTTFaVEF3TkRjMCIsInQiOiJnN2VWWElpSnpaSkE1VEJvWStpRUVvV0E4cVFKMjFPcHk4UGtkMmZocFJ2SkE2U0FVelk5M0loRGtLMk1xUGp0YlFjdG5pM21kQUhWeGlCK2JKeFAyeHhcL0Ewa1IxVzhpOVlFekFxbDQzd2ZtSUw5a3c1ZGZvYnBEMjA4bWc3V3UifQ%3D%3D&mrkid=715787

Anthem announced Thursday that it plans to buy Beacon Health Options, the country’s largest independently held behavioral health provider.

05/07/2019

Effectively fighting insurance claim denials is a true art. I have figured out very effective ways to get these claims paid. It amazes me how often they expect providers to just write off the claim because it was denied. You have rights.

07/16/2018

MIPS is not as hard has you may think. I found a loophole to save my clients thousands of dollars by simply reporting some things that they are already doing. Let us know if we an help you avoid that negative payments in 2019.

06/28/2018

We just celebrated 17 years in business. Thank you to our community for making this possible.
~AMB Team

06/23/2018

Need some help with your medical billing? Give us a call today and let us help you get your billing on track.

08/04/2017

BLUE CROSS :

You may have already heard, but we wanted to let you know that Anthem Blue Cross (Anthem) will no longer offer many of our Affordable Care Act (ACA) individual health plans in California starting Jan.1, 2018. Until then, everything will stay the same.
What should I do if I have an individual ACA health plan?
If this affects you, you'll have plenty of time to prepare. You'll get a formal notice from us in the mail telling you that your plan is ending in 2018. As open enrollment gets closer, you can look at other plans so you can find new coverage. We'll help you connect with someone who can assist you in finding a new plan, even if it's not with Anthem. In the meantime, you can log into Anthem.com/ca to contact us or view the details of your current plan.
Why are you doing this?
Unfortunately, uncertainty in the health insurance market does not provide the clarity and confidence we need to offer affordable coverage to our members in 2018.

This is huge for all of the physicians and billing office in California.

05/30/2017

Medicare has just rolled out the triple security authentication for their portal. Have you been able to access your account? Do you think that is a bit excessive or right in line with security?

02/28/2017

Drug Screen billers:

If you bill for drug screen testing you may be getting frustrated like the rest of us. Medicare has admitted to a system error and will be reprocessing all of the claims they rejected in error.
As for the timeframe in the reprocessing they do not know.

Sounds like Medicare 😊