Medigap

Medigap (Medicare Supplement plan) associate to different private supplemental health insurance plans buy the Medicare subscribers in the United States. Medigap provide coverage for medical expenses covered by Medicare. Medigap is “Supplemental Medicare Coverage”. Medigap is a private program sold by insurance companies or managed-care health organizations that plug/fill the gaps in the Original Medicare Plan coverage; it is specially designed to supplement your existing Medicare coverage. Insured must have Medicare Part A and B to apply for Medigap.
There are ten different standard Medigap plans. All of the plans are offered in most states. (Minnesota, Massachusetts and Wisconsin are exceptions). The ten standard plans labeled through "A" to "N." Each Medigap may offer different plans. A is the basic; N is the most comprehensive.
Medigap is private insurance, the insurance policy rules and coverage can vary from state to state. Some states such as Massachusetts, Minnesota, and Wisconsin required Medigap insurance to provide additional coverage. They pay most of Medicare deductibles and coinsurance amount. Some of the services which are not covered by the Medicare, it covers the Medigap.
Some Medigap plans may not covered specific health conditions for the first 6 months. Medigap policies are required to cover your preexisting condition after they have been in effect for you for those 6 months.

Individual Practice Associations

An Individual Practice Associations (IPAs) is an association of doctors or organization who maintain their own office and group. That has contracted with an HMO to give services to the HMO subscribers. An HMO may contract with an IPA which contracts with individual doctors to treat patients at reduce cost fees, on a capitation basis or fee for service reimbursement. The doctor joining an IPA, it may need to pay a membership fee.

HIPPA

Health Insurance Portability and Accountability Act (HIPPA), was established by the U.S. Congress in 1996, and became effective from 07-01-1997. The aim of the HIPAA is to improve the effectiveness and efficiency of the health care system, portability and constancy of health insurance coverage.

The HIPAA Privacy Rule builds national standards to keep individuals’ medical records and personal health information.

HIPPA gives patients more authority over their health information, and arrange limits on the usage and release of health records.

Establishes allocate safeguards that health care providers and others must accomplish to take care of the privacy of health information.

Benefits

Low administrative costs
Increasing capability for patients and providers
customer satisfaction
Improved privacy information

Who does HIPAA affect?
Beneficiary
providers
Hospitals
Employers who provide health insurance
payers
Public health authorities
Billing agencies

COBRA

The Consolidated Omnibus Budget Reconciliation Act – 1986 gives workers and their dependents. Who lose their health benefits they have to right to choose to continue group health benefits provided by their group health plan for limited period under specified circumstances. Such as voluntary or involuntary, job loss, modulation between jobs, deceased, divorce, and other life events. Eligible individuals required to pay the total premiums for coverage the cost to the plan.
Even though the COBRA subsidy makes low expensive alternative for some employees, others may be better served by commercial insurances.
COBRA outlines explain how employees and dependents elect continuation coverage, also required employers and plans to provide notice.

DBU Medical Billing and Coding

http://www.medicalbillinglive.com/cmd.php?af=1367825

Radiology and Pathology Modifiers

TC Technical component
26 Professional component
GG Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day.

PI Positron Emission Tomography or Computed Tomography to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing.

PS Positron Emission Tomography or Computed Tomography to inform the subsequent treatment strategy of cancerous tumors when the beneficiary's treatment physician determines that the PET study is needed to inform subsequent anti-tumor strategy.