Medicare Chiropractic Myths
There are several myths about Medicare and Chiropractic Services. It is not to say they were not once true, but as of 2008 here are a few of them.
Myth 1: Medicare Patients are allowed 12 visits per year. There are no caps/limits in Medicare for covered chiropractic care rendered by chiropractors who meet Medicare’s licensure and other requirements.
Myth 2: Chiropractors can opt of Medicare. Chiropractors are not allowed
to opt out of Medicare. Chiropractors are either 'participating' or
'non-participating' (non-par) status with Medicare.
Myth 3: Non-Par Chiropractors do not have to bill Medicare. Non-Par Chiropractors are participating with Medicare, but have elected to receive payment in a different method than participating providers. Non-Par providers may be reimbursed directly from the patient, but then file a claim with Medicare to reimburse the patient, with the amount that the patient paid.
Myth 4: If you are Non-Par, then you will not be audited. If a chiropractor files claims, then they can be audited. If the chiropractor doesn't file claims, they will be penalized.
Myth 5: You should get an Advance Beneficiary Notification (ABN) signed once for each patient, and it will apply to all services, all visits. Though we do not find most physicians need to have one signed each visit, there should be new ones signed when treatment or services change. For example, hot packs are not covered, yet the patient needs the service. The patient signs and ABN for that particular service. Three months later, the patient needs a knee adjustment (98943), this needs to be added to the ABN, and at a minimum have the patient initial the addition, stating they were informed.
Posted on Tuesday, August 12, 2008 at 9:22 AM
Posted in Insurance (RSS), Insurance DC (RSS)