Tag: medicare benefits

Medicare Advantage plans benefit

Medicare Advantage Plans Benefit from Expert Medical Billing

As the U.S. healthcare system continues to evolve, Medicare Advantage (MA) plans have seen rapid growth, offering seniors an alternative to traditional Medicare. With more than 30 million beneficiaries enrolled in Medicare Advantage as of 2025, the demand for administrative efficiency and accurate claims processing has never been greater. Medical billing companies play a pivotal […]
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New Medicare enrollment application

New Medicare Enrollment Application: A Comprehensive Guide

Enrolling in Medicare can feel like navigating a maze of paperwork and deadlines. This comprehensive guide aims to simplify the process, focusing specifically on the new Medicare enrollment application. We’ll break down the different parts of the application, explain eligibility requirements, discuss enrollment periods, and offer tips for a smooth and successful enrollment experience. Understanding […]
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Medicare Advantage Plans and the Two-Midnight Rule

Medicare Advantage Reimbursement: Understanding CMS Rules and the Two-Midnight Debate

Medicare Advantage (MA) plans play an increasingly important role in the U.S. healthcare system, but questions remain about whether reimbursement practices consistently align with Centers for Medicare & Medicaid Services (CMS) regulations. As hospitals face rising operational costs and growing financial pressures, understanding Medicare Advantage reimbursement requirements is essential for providers seeking fair payment and […]
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“Defensive” Undercoding Is Indefensible

“Defensive” Undercoding Is Indefensible

Undercoding, or reporting a lesser service than was performed and documented, is sometimes employed as a defensive strategy to stave off claims denials or audits. But, undercoding can make a provider an outlier, and may create consequential patient care, compliance, and financial liabilities. For example: Undercoding Leaves Money On The Table, Driving Down Provider Reimbursement […]
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Non-Coverage Denials

Non-Coverage Denials: Cause and Cure

Explanation of Medicare Benefits (EOB) error message 96 Non-covered charge was the No. 1 reason for claims denials in December in all of Medicare Jurisdiction H, according to the region’s Medicare Administrative Contractor (MAC). “Prior to performing or billing a service, ensure that the service is covered under Medicare,” Novitas Solutions says on their website. This should be […]
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