Medicare and Medicaid : Lesson 14

Medicare

This lesson will discuss how to complete claim forms for Medicare administrative contractors. Students will learn about the Medicare enrollment process and how to differentiate between Medicare Part A, Part B, Part C, and Part D coverages. They will learn about other Medicare-related health plans, Medigap, private contracting and employer/union health plans. They will learn how to calculate reimbursement between participating and nonparticipating providers. They will also learn how to interpret a Medicare Summary Notice, apply billing notes to CMS-1500 claim forms, and complete: Medicare primary, Medigap, Medicare/Medicaid (Medi/Medi) crossover, secondary, and roster billing claims.

Medicaid

This lesson will discuss how to complete claim forms for Medicaid administrative contractors. Students will learn the guidelines for Medicaid eligibility and the covered services. They will learn how the payments for Medicaid are processed and how to apply Medicaid billing notes to CMS-1500 claims. Finally, they will learn how to successfully complete Medicaid primary, secondary, mother/baby and SCHIP claims.