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Ophthalmologists advised to get to know Medicare Part C
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WAIKOLOA, Hawaii — Ophthalmologists need to pay attention to Medicare Advantage organizations, the fastest growing part of Medicare, a speaker said here.
“This is Part C Medicare. It’s the fastest growing part of Medicare. Part B is not growing at all,” Kevin J. Corcoran, COE, CPC, FNAO, said at Hawaiian Eye.
Kevin J. Corcoran
One-third of all Medicare beneficiaries are served by Medicare Advantage, Corcoran said. “One of the things that those of you who are optometrists or cataract surgeons would be concerned about is non-covered services,” Corcoran said, listing such services as refractions, premium IOLs, cosmetic surgery and refractive surgery.
Medicare Part C has its own process to follow and it is not possible to use an advance beneficiary notice for Part C patients as is done for Part B Medicare, Corcoran said.
Key considerations are that the program may require itemized lists of services with CPT codes and ICD-10 codes, or submission of codes for non-covered services on claim modifiers may be required, according to the presentation.
“If you don’t follow the process, they can ask you to refund the beneficiary,” Corcoran said. – by Patricia Nale, ELS
Reference:
Corcoran K. What’s new in 2016? Presented at: Hawaiian Eye; Jan. 16-23, 2016; Waikoloa, Hawaii.
Disclosure: Corcoran reports he is consultant for Corcoran Consulting Group.