Newsletter

Chiropractic Medicare
A. New Fees for 2011
B. Medicare and PI (or WC) cases

Updated: February 21, 2011
Dear Doctors and Staff,

A. FEES: All Medicare Carriers have posted the "NEW" fees for 2011. Go to your Medicare Carrier web page, click FEES. Go to 98940, 98941,98942 to find your fees in your specific local. Remember....the 98940, 98941, and 98942 WITHOUT the (#) sign are your fees in your office for your Medicare patients. The codes with the pound (#) sign are your fees if you adjust your Medicare patient in a facility other than your office.

B. Medicare PI, WC, or other payor than Medicare: When you have a Medicare patient with another payor than Medicare....remember, this is still a Medicare patient and you must follow Medicare Guidelines including billing to Medicare.

When you bill the PI insurance company for this Medicare Carrier, use all modifiers. Example: 98941 AT GA. The AT is active treatment and the GA tells Medicare carrier the patient signed the ABN because Medicare will not pay. Non-participating providers must also remember to NEVER bill the PI or WC insurance above your limiting fees. Participating providers may bill their regular PI fees on this Medicare patient.

Make a copy of the claim to the PI Insurance, one for your records and one you will mail to the Medicare Carrier. Item 10A thru 10C will indicate to the PI insurance that it is their responsibility and will also indicate to the Medicare Carrier NOT to pay this claim. It is billed to Medicare along with a bill to the PI...first because it is the federal law. Secondly, if the patient looses the PI case, now a copy of denial from the PI is sent to Medicare and now Medicare will pay.

NOTE: If you receive money from Medicare on a PI case.....and it is not paid back in a timely manner.....Medicare will take that amount out of your Social Security! This and much more is covered in our Chiropractic Medicare DVD and booklet.
BOTTOM LINE: If you wish to learn how to do Chiropractic Medicare correctly, including "documenting" by federal standards, please consider ordering our Chiropractic Medicare DVD and booklet. It explains piece by piece every important step in doing and billing Chiropractic Medicare so there are no limits for the chiropractic adjustment. If you are audited you will have done Medicare correctly and win your audit. You and your staff will be very happy you have this important and mandatory information. I promise it will make a difference in your understanding of Medicare and how you bill Medicare.
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Keep in mind, Medicare is the only insurance type program that if done incorrectly is fraud, a felony, a fine and/or jail.

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I promise you will be more than satisfied that you made the right decision to purchase this information or attend our presentation. Please give me a call if you have questions. 1-618-395-3162

Best regards,
Dr. Gary R. Street


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