WHAT DME IS COVERED BY MEDICAID?
- Medicaid is a State and Federal partnership, which provides coverage for low income, elderly, disabled, and families with children. Medicaid will cover Durable Medical Equipment (DME) that is medically necessary. Medicaid has multiple coverage plans, therefore copay amounts may vary.
- It can be provided outside of nursing homes, when this occurs it is referred to as Home and Community Based Services or Waivers. Individuals participating in a Medicaid Waiver program typically have a higher degree of personal involvement in the acquisition of DME than Medicaid Nursing Home residents.
WHAT IS MEDICAL BILLING?
- Is a payment practice within the United States Health System. The process involves a health care provider submitting, and following up on, claims with health insurance companies in order to receive payment for services renderes; such as treatment and investigation.
- The same process is used for most insurance companies, whether they are private companies or government sponsored programs. (ex. Cigna, Medicare and Medicaid)
- In Medical Billing we used Medical coding.
WHAT ARE THE 3P’s IN MEDICAL BILLING?
WHAT IS EDI?
- It is also called Electronic Data Interchange
- Is the concept of businesses electronically communicating information to that which was traditionally communicated on paper.
- The electronic systems that carry claims to a central clearing house for distribution to individual carriers.