NewsletterNovember 6, 2012
Chiropractic Medicare & Compliance
Just a small reminder:
No matter where I speak, in the Eastern States or Western States, North or South...I still run into fellow Chiropractors who do not seem to be aware that it is a federal law as per Social Security Act (Section 1848(g)(4)) that when they adjust a Medicare patient, it is mandatory claims submission in a reasonable amount of time (one year or less).
If you have no Medicare number and/or have not completed a CMS 855i application, you are not qualified to file a Medicare claim to a Medicare Carrier. This also means you are not qualified to take care of a Medicare patient. If you are adjusting Medicare patients and not billing Medicare for your patient, you have breached the federal law and may be fined up to $10,000.00 per adjustment.
The simplest of all rules in Medicare is being overseen by a surprising number of chiropractors. If you know any that are not billing Medicare, please confront them, as you may save them big dollars and embarrassment.
We all must keep in mind that our seniors in the Medicare program pay premiums each and every month. It is our job to document and bill Medicare so correct reimbursement is part of the normal Medicare process.
NOTE: We must know how to do Medicare to keep out of trouble and make sure our seniors are reimbursed. We also must become Medicare Compliant to stop fraud and abuse. Your compliance in your office should be nearly completed by now. For the required seven (7) categories we must respond to by creating a Medicare Compliance Program and procedures in your practice, follow this link: http://www.cms.gov/Medicare/Medicare-Contracting/MedicareContractingReform/Downloads/compliance.pdf