Have you been to your Medicare Carrier’s website yet? Each
state has a Medicare Administrative Contractor (MAC) with specific
Jurisdictions. You
should be familiar with it by now. If not, please go there today. You can find
your Carrier by Googling your state name with “Medicare Part B” or going to the
CMS link below:
https://www.cms.gov/Research-Statistics-Data-and-Systems/Monitoring-Programs/Medicare-FFS-Compliance-Programs/Review-Contractor-Directory-Interactive-Map/
First item to research about your carrier, find your LCD
or Local Coverage Determination. If you think all chiropractors in all states
follow the same Medicare Guidelines, you are only half right! The Medicare
Carriers determine the LCD by their own interpretation of the guideline. This
is extremely important as of October 1, 2015. Unless you have been living under
a rock, you know that we are using ICD-10 codes now and with that change came a
brand new LCD. Make sure you know the codes you are allowed to use.
Second important item to know is your Carrier has an online
portal. Whether you are a Participating or Non-Participating Provider, you can
use their portal. It is a fantastic tool. You can get patient eligibility verification, duplicate remittance advice, submit
corrections, submit re-determinations, check status of appeals, send a secure
inquiry to the Carrier and receive a response within the portal.
