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Medicare, Medicaid, Life and Health Insurance/Questions Answered by Expert Adelaide Rose
| Subject | Date Asked |
| Medicare, secondary insurance, and | 8/2/2010 |
| Q: I recently enrolled in Medicare as my primary insurance while UHC remains my secondary through my ... A: Jel, physicians that provide services to medicare patients should be enrolled in the medicare ... | |
| Medicare, secondary insurance, and "non Medicare" Service Provider | 8/2/2010 |
| Q: I recently enrolled in Medicare as my primary insurance while UHC remains my secondary through my ... A: Jel, I'd like to believe that you should do what UHC is telling to do and it should work, but ... | |
| daughter on medicaid | 7/24/2010 |
| Q: "I have an 19 yr old daughter who lives with her mother in the state of Fla. She is on medicaid but ... A: Assuming Medicaid was active at the time of service, Medicaid should pay for the remaining balance ... | |
| Secure Horizons, United Healthcare, AARP Complete | 4/18/2010 |
| Q: My mother&neighbors attended a group "information"(solicitation)presentation given by local agent of ... A: I certainly didn't mean anything specific to your situation, I'm sorry if I worried you. If your ... | |
| Being forced to choose filing Medicaid OR Private Insurance | 3/30/2010 |
| Q: My daughter just became available for Medicaid in LOUISIANA and she has private insurance on my ... A: If your daughter is covered under both private insurances, these have to be billed first. Then ... | |
| dme billing | 3/18/2010 |
| Q: I have a private insurance which pays 17,000/year for dme and medicaid as a secondary payor source ... A: Jack: a couple of things in response to your question. - the DME company probably had you sign a ... | |
| medi medi billing | 3/10/2010 |
| Q: Our family practice does not accept medi-cal/medicaid. If a patient has medi medi can we bill only ... A: I'm sorry, but I am uncertain of the acutal "rules" for your state. I believe that you may not ... | |
| Medicaid Billing | 3/1/2010 |
| Q: I am a licensed psychotherapist who works in a private group practice in New York City. Most ... A: I am certain that the only way someone else can bill for you is if they have a practice/facility ... | |
| Medco prescription | 2/20/2010 |
| Q: I have HIP insurance with the National Writers Union. Although my doctor writes two prescriptions ... A: I would contact your HR department and speak to the person in charge of your plan administration. ... | |
| Unpaid medicaid Bills | 2/10/2010 |
| Q: I am working in Healthcare domain. We are having some kind of problem while billing claims to ... A: Medicare HMO is still a Medicare product. Regardless of who the primary insurance is (Medicare, ... | |
| Medicare as secondary insurance | 2/2/2010 |
| Q: I work in health care. When presented with more than one insurance cared,how can I determine which ... A: If the patient has Medicare and Medicaid, that's easy...Medicaid is always the last payer of resort. ... | |
| Medicare/Medicaid and collections | 12/29/2009 |
| Q: We are a specialty practice in WA. state with many Medicare and Medicaid patients with outstanding ... A: Jeannette, If a patient is on Medicaid the balance should be paid in full, unless the reason why ... | |
| How to bill Medicaid | 12/18/2009 |
| Q: I am a Registered Nurse with my own Independent Nursing business. A friend has a sister who is ... A: I'm not sure what type of provider you consider yourself to be (other then RN of course), but you ... | |
| How to bill Medicaid | 12/18/2009 |
| Q: I am a Registered Nurse with my own Independent Nursing business. A friend has a sister who is ... A: Judy, Are you an approved Medicaid provider? if not, you can't bill. Unless you're working for an ... | |
| Medicare | 12/12/2009 |
| Q: My Mom is telling me that Medicare is not paying her dr and dentist bills. Could you please give me ... A: Jim, There could be a multitude of reasons why this is happening. I won't be able to help without ... | |
| claim denied | 11/11/2009 |
| Q: My husband, my 9 year old son and I went to check-up in different time between March to June, 09. ... A: Mei, You need to make sure that the blood work your husband's co-worker is getting is the same. If ... | |
| claim denied | 11/11/2009 |
| Q: My husband, my 9 year old son and I went to check-up in different time between March to June, 09. ... A: Mei, You don't state the reason why Aetna is not paying the entire bill. However, the first place ... | |
| insurance refusal to pay for hip replacement | 10/29/2009 |
| Q: I am currently covered by my husbands medical insurance through his pipefitters local union #598. ... A: Dona, I would have your doctor write a letter of medical necessity (if it's warranted) and have the ... | |
| medicaid | 10/6/2009 |
| Q: I am divorced and provide health insurance coverage for my children through my employer. My ex has ... A: Bryan, If your children are covered under your insurance, then your insurance is primary. Mediaid ... | |
| i need a pcp for my daughter asap | 9/23/2009 |
| Q: I need a pcp for my daughter who is 2 years old. She is on medicaid now and i cant find a list of ... A: Amber, I'm sorry but I can't give you a list or website...but I was wondering if the problem is ... | |
| lap-band surgery | 9/16/2009 |
| Q: I would like to find out if medicare and medicaid will cover lap-band surgery if it is deemed ... A: Sherry, if your doctor can deem this surgery medically necessary, Medicare and Medicaid may cover. ... | |
| mother | 7/27/2009 |
| Q: could you explain to me what QMB is and how my mother can get on this to help on her medical ... A: Marsha, I took the following information right from the CMS (Center for Medicare/Medicaid ... | |
| Transferring Medicaid benefits from VA to CA | 7/26/2009 |
| Q: How do I help my son transfer his Medicaid benefits from Virginia to California? Would he need to ... A: Brian, You will need to contact CA Medicaid, every state's requirements are different. Sometimes, ... | |
| which insurance is primary and secondary | 7/25/2009 |
| Q: I have gateway healthplan medicare assured, the Access card and medicare. I'm not sure which is my ... A: Kelly, I'm not sure what type of plans these are by just their name. However, this is how it ... | |
| Coordination for Benefits for past 5 years. | 7/8/2009 |
| Q: My daughter, age 27, is disabled. Her Dad carries her on his Federal BC/BS policy and she has ... A: Betsy, Depending on the state, the limitations to be able to go back are different. Most states ... | |
| Collection money from medicare pts | 6/25/2009 |
| Q: When a patient comes in for a visit, is it illegal to collect the coinsurance or deductable for that ... A: Terri, Assuming that you are an in-network provider, you may not collect any of the patient's ... | |
| Medical Records | 6/23/2009 |
| Q: How long must a physicians office keep records on site for patients. that have not been seen. We ... A: The charts don't have to be kept in house, however, the charts must be easily accessible in the ... | |
| double coverage | 6/8/2009 |
| Q: Is it necessary to take a write off from both the primary and secondary insurance companies, or just ... A: If you take the write off of the biggest, you are in essence also taking the write off of the ... | |
| double coverage | 6/8/2009 |
| Q: Is it necessary to take a write off from both the primary and secondary insurance companies, or just ... A: Andria, I'm assuming by write-off you mean a contractual allowance, the difference between what was ... | |
| office visit | 6/4/2009 |
| Q: Yes i would like to know if medicare will pay for a patient to come in the office just to pick up a ... A: Robien, a patient picking up a script does not constitute a billable service that you're providing. ... | |
| insurance | 6/4/2009 |
| Q: i have hip through my job.I had gastric bypass two years ago and would like to know if there is any ... A: Krystal, Not every employer purchases the same type of medical insurance, therefore coverage ... | |
| insurance write-offs | 5/27/2009 |
| Q: I have a claim for dental implants for $5310.00. These were needed due to a birth defect so they ... A: Tracey, If the provider is participating with your insurance, they should accept the amount that ... | |
| tummy tucks for medical reason | 5/19/2009 |
| Q: i have been told by 3 doctors i need a tummy tuck due to the many bad yeast infections,rashes ... A: Audrey, If a doctor is not willing to write a letter of medical necessity to your insurance ... | |
| medicaid prescription coverage | 5/15/2009 |
| Q: My little brother is a medicaid recipient because he was born with meningitis of the brain, does ... A: Renai: Unfortunately I'm unable to answer this question. I advise you to contact the Medicaid ... | |
| How to write to HMO Medicaid | 5/14/2009 |
| Q: My doctor knew ahead of time I was going to see her to get a referral to see a Chiropractor, ... A: Glad to hear that you are feeling better. You can certainly write an appeal to the Medicaid HMO and ... | |
| what surgerys are covered? | 5/8/2009 |
| Q: my name is cynthia im under going treatment for chronic pain due to degenerated spine diseaes ... A: Within Medicaid, there are several programs that cover and not cover certain procedures. My ... | |
Medicare, Medicaid, Life and Health Insurance
Answers by Expert:
Adelaide Rose
Top Expert on this page
Expertise
Any questions related to Revenue Cycle Management and homecare/facilities operation processes.
Experience
I have been in the healthcare industry since 1992. My experience comes from working in a multi-physician practice setting, homecare, ambulatory care and consulting engagements with a "Big 5" firm.
Education/Credentials
Management
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