| Subject | Date Asked | Expert |
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| QMB BENEFITS In FLORIDA | 10/2/2008 | Merry Schiff |
Q: I was approved for Qmb 8/08 and Have Medicare as of 08/08.I live in Florida While visiting my sister ...
A: Medicaid is state specific and you are covered by Medicaid in FL and not in KY. Since this was an ...
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| Medicare Share of Cost | 10/2/2008 | John Pedit |
Q: I am writing in concern of my mother just got approved for Medicare Share of cost in Orlando, FL. It ...
A: Her Medicare card is proof of coverage under Medicare and most doctors accept it. If she is in ...
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| Billing 2 insurances for one visit | 10/2/2008 | Tricia |
Q: We have a patient that the doctor sees for both her BWC issue and her health issues. She comes in ...
A: I would think so---------as long as you are providing a different service for each carrier. If the ...
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| dental insurance | 10/2/2008 | Tricia |
Q: what dental insurance has the lowest at office co-payments. my company will pay up to 250.00/month ...
A: Most dental plans are similar.....they usually pay between $1000-$1500 per year with a $25-$50 ...
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| billing | 10/2/2008 | Tricia |
Q: I was at Kaiser, in the hospital, for 3-4 days without any insurance. I called them to get my bill ...
A: I doubt very much that the department who collects on bills communicates with the department who ...
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| copays | 10/2/2008 | Tricia |
Q: We have ADS softwear in our office and I was wondering how do you submit a copay to the secondary ...
A: I do not know this software--there are hundreds of billing software types and I don't know them all. ...
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| florida medicaid | 10/1/2008 | Tricia |
Q: i am moving back to florida in a month, and my dr here in ohio medicaid is coverd for a breast ...
A: Every state is different and has different guidelines------just because Ohio Medicaid will cover ...
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| Medicare | 9/29/2008 | John Pedit |
Q: To follow up with what someone else ask about switching form a medicare program (ie-Blue Shield) to ...
A: You appear to be in an Advantage plan, an HMO. To go from one advantage plan to another, you simply ...
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| medicare HMO non contracted plans | 9/29/2008 | Merry Schiff |
Q: If a patient has a Medicare HMO (ie. humana)that is not contracted with the hospital, is there still ...
A: The payment would have to be made by the HMO to the hospital if it was a true emergency. They do not ...
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| Submitting bills to medicate | 9/28/2008 | John Pedit |
Q: I would like to purchase a power wheelchair online. There is a significant difference if the ...
A: Suzanne What you want to do sounds good, but it is the hard way to go and very frustrating. Also ...
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| Louisiana Medicaid | 9/27/2008 | Tricia |
Q: I was living in Gonzalez, LA for about 6 months. While I was down there I found out I was pregnant ...
A: The phone number you have is the one that is listed on LA's Medicaid website. However I have pasted ...
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| Medicare and Lipid Panel Blood tests | 9/26/2008 | Tricia |
Q: Since 2002 I have had medicare pay for blood tests to check for liver problems and they have paid ...
A: Medicare guidelines and rules change each year.......however find out why they were rejected the ...
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| medicare insurance with AARP secure Horizons in colorado | 9/26/2008 | John Pedit |
Q: My mother in law has been living in Denver area and will be relocating to New Mexico due to ...
A: When she moves out of a plan coverage area she is entitled to change plans, and if she does so ...
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| Breast reconstruction after mastectomy for breast cancer | 9/25/2008 | John Pedit |
Q: If a woman has breast reconstruction after a mastectomy for breast cancer, does her managed medicare ...
A: The doctor is the one that makes the decision if it is medically necessary and assigns the proper ...
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| Medicare | 9/25/2008 | Tricia |
Q: My mom had Medicare as her primary and AARP as secondary.. she passed away 6months ago.. and we are ...
A: Usually the providers bill Medicare directly since they require a NPI # in order to pay. So what I ...
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| Billing patient while waiting on appeal | 9/24/2008 | Tricia |
Q: Can my provider bill me for something I am personally appealing with my insurance?
A: Yes they can but usually as a courtesy they will hold off until you get an answer from your ...
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| DENTAL CLAIMS FROM NYS | 9/24/2008 | Tricia |
Q: I am a office manager of a pediatric dental office. we have a very big problem with nys medicaid ...
A: Getting paid by insurance carriers is a big game unfortunately--------you got to keep calling, ...
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| Dental Claim Denied | 9/23/2008 | Tricia |
Q: Last July my dentist supplied the required info to my insurance co's website for a printed treatment ...
A: You have to give them a good reason why your appeal was past their time limit to file the ...
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| Medicaid in PA | 9/23/2008 | Merry Schiff |
Q: I was widowed 3 years ago. I am juvenile diabetic and extremely brittle. I was on the insulin pump ...
A: Medicaid is determined by income and you may be over the limit for your state. I would definitely ...
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| COB with Medicaid/med assistance? | 9/23/2008 | Tricia |
Q: 2 dependent children (under 19) are fully covered under my employers fully insured health/dental ...
A: Usually it is a year. Not all providers participate with Medicaid there for they can not bill them ...
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| COB with Medicaid/med assistance? | 9/23/2008 | Tricia |
Q: 2 dependent children (under 19) are fully covered under my employers fully insured health/dental ...
A: Medicaid pays very little and if they deem a bill to be paid beyond their allowable, then they will ...
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| Unjustified medical nill | 9/23/2008 | Merry Schiff |
Q: I am currently billed $243 for an E.R. visit, and I'm wondering if there is a way for me to cancel ...
A: Actually, no. The fees can vary. You were obviously charged for a very limited visit. The person who ...
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| Medicare | 9/22/2008 | John Pedit |
Q: My mom lives in Central Oregon, approximately one hour to two hours from Boise ID. In July of 2007, ...
A: You asked about Medicaid, so that is what I will address. I am in Michigan, and since the ...
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| Medicaid HMO cut letter | 9/22/2008 | Kyla Kelim |
Q: I work for a longterm care facility, I have recently been asked by a Medicaid HMO company to have a ...
A: Ms. Stevens, I do not typically answer these questions. Its my opinion, in this and other areas ...
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| Unjustified medical nill | 9/22/2008 | Merry Schiff |
Q: I am currently billed $243 for an E.R. visit, and I'm wondering if there is a way for me to cancel ...
A: When you signed the paperwork at the hospital, you said that you would pay the bill. The dr charged ...
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| Medicare Part A | 9/22/2008 | Merry Schiff |
Q: .he broke his femur and fractured his hip...he has to have surgery today and it will be only an ...
A: Medicare Part A and B come into play here. I assume that he has Original Medicare and not an HMO. If ...
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| Medicare Medicaid dual billing | 9/22/2008 | John Pedit |
Q: I currently work for a podiatrist that sees many Medicare/Medicaid eligible patients. They are ...
A: I can not answer this question because it is out of my expertise . However it sure looks like ...
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| mother-in law says she does not have medicare | 9/22/2008 | John Pedit |
Q: My motherinlaw is 90 years old and only has about 700 a month from social security. She does not ...
A: Go to Benefits.com and enter her information. They will check about 400 programs and come up with ...
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| Medicaid From Another State | 9/21/2008 | Kyla Kelim |
Q: My mother is currently on Medicaid through the state of Florida. I live in Massachusetts and ...
A: Allison, someone is Massachusetts is going to be better off answering this question. Vaguely, you ...
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| mirena IUD | 9/21/2008 | Merry Schiff |
Q: my doctor is ordering this IUD for me and said it may not be covered by medicare but said ablation ...
A: I agree with you..but Medicare and other plans only pay for what is medically necessary and ...I ...
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| codes, qualifying treaetments | 9/21/2008 | Tricia |
Q: okay, does medicare cover any of the following, intravenous vitamin c,i.v. ascorbic acid, i.v. ...
A: You would have to go onto Medicare's website for your state/region and check each of the above ...
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| inheritance and medicaid/food stamps | 9/20/2008 | Kyla Kelim |
Q: food stamps ($140.) and medical insurance through Medicaid/Medicare. This is all NY state. I am ...
A: Lynn, I am a bit confused, with your income, you should not be on Medicaid. The inheritance will ...
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| What is the medicare reimbursement for weight loss surgery | 9/19/2008 | Merry Schiff |
Q: I have just bought a new insurance policy because the health insurance that I have through my ...
A: I cannot give you an answer. Medicare reimburses according to geographical location. You can be ...
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| Inheritance to make son inelligible for medicaid? | 9/19/2008 | John Pedit |
Q: In Missouri, my 26 year old son is diagnosed with diabetes and an extreme case of depression, has no ...
A: Sorry, but you just about have it all figured out. Medicare regulations vary from State to State. ...
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| Monies used to Qualify Mom for Medicaid | 9/18/2008 | Tricia |
Q: As POA for my dyeing mothers affairs, I recently cashed in 4 CD's to buy an irrevocable burial fund ...
A: You did what you had to do and as you say if your mother did not go on Medicaid that money would ...
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| Need medicaid to approve hysterectomy | 9/17/2008 | Tricia |
Q: I am a 26 year old female. I have had my tubes tied, and endometrial ablasion. But have still be ...
A: It is hard to say...Medicaid will review all the medical information and determine if they feel it ...
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| COORDINATION OF BENEFITS WITH TWO HEALTH PLANS AND MEDICARE | 9/17/2008 | John Pedit |
Q: Our member is actively at work under age 65 for a group of more than 100. Her spouse is retired ...
A: Hard to tell. Normally it would be his plan, then hers, then Medicare. But the commercial ...
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| Medicare coverage for refugee and permanent resident | 9/17/2008 | Kyla Kelim |
Q: Do a person on refugee or permanent resident, qualify for medicare once he or she is over 65 years? ...
A: RJ, to be eligible for Medicare you must be 65 or older, or have been disabled for more than 2 years ...
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| Mom in nursing home | 9/17/2008 | Kyla Kelim |
Q: My Mother has been on Medicaid for a year now and just recently went into the nursing home. Her ...
A: Marlene, this is the magic question right now for millions. This is how it works: When you go into ...
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| moved, hmo not covering my area | 9/17/2008 | John Pedit |
Q: My mother-in-law is now living with us. needs 24/7 care. Her HMO(healthsprings) doesn't recognize ...
A: Go to Medicare.gov===scroll down to and click on Compare plans in your area===search the plans and ...
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