Medicare, Medicaid, Insurance, HMO problems/Expert Profile


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Merry Schiff

U.S.
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Expertise

I am very familar with Medicare and general insurance questions. I can answer general questions about HMO's.

Experience in the area

I have been in the medical billing industry for 50 years. I have helped develop software for this industry. I am a consultant to billers and the medical profession.

Organizations

I am the Executive Director of NEBA, a medical billing organization with nearly 1000 members.

Education/Credentials

I have been teaching medical billing for many years as well as being a published author with Pearson Education. One book on medical billing (nearly 800 pages) and one on HIPAA.

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Recent Answers from Merry Schiff

2009-10-30 medicare & hmo's & fee for service plan:

I do not understand why you have Medicare and an HMO. Are you certain that you are not in an Advantage Plan, Medicare Part C. That is my gut feeling as Medicare does pay for PT with a doctor's referral

2009-10-23 Medicare and Cobra Insurance High Copayments:

You need to find out if your UHC COBRA plan covers your drugs and how much it covers. You are probably getting your drugs from their mail order plan which. in your case, may be from Walgreens. You need

2009-10-13 Submitting Bills to Medicare:

David..She had better know how to do it. It is a Federal law that she must submit the claim. And she can only charge the limiting charge. To find out what that is, you will need the CPT code that she is

2009-10-13 Submitting Bills to Medicare:

If the psychologist has opted out of Medicare, she must inform the patient that for two years, neither she nor the patient can bill Medicare. I would call Medicare to see if she actually signed a contract

2009-10-06 medicare and hmo coverage:

There is no reason to have an HMO as secondary coverage..in fact, they probably would not let you. You need a secondary insurance to pick up the 20% that Medicare does not pay..You can only use one drug

 

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