Medicare beneficiary ombudsman - PowerPoint PPT Presentation


eHealth - Your Trusted Source for Insurance Products and Options

eHealth is a leading online marketplace offering a broad choice of insurance products, including Medicare Advantage, Medicare Supplement, Medicare Part D plans, individual and family health insurance, small business coverage, and ancillary health insurance products. With over 25 years of experience,

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Understanding Medicare and Long-Term Care Coverage Options

Health Insurance Counseling and Advocacy Program (HICAP) and Legal Assistance for Seniors (LAS) offer free services to help seniors understand and navigate Medicare, long-term care, and related legal issues. LAS supports seniors' independence and dignity by providing assistance with government benef

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Medicare Advantage Plan Payment Rate Trends Over the Past Decade

Analyzing the annual percentage changes in national per capita Medicare Advantage growth rates over the past decade reveals fluctuations in payment rates, with an average annual growth rate of 2.87%. The data reflects the evolving landscape of Medicare Advantage plan payments and policy updates. Thr

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Medicare Advantage Enrollment Trends and Payment Mechanisms

Medicare Advantage enrollment has significantly increased in the past decade, with payments being determined by benchmarks, bids, and quality incentives. The prevalence of chronic conditions is comparable between Traditional Medicare and Medicare Advantage, excluding Special Needs Plans. Dual-eligib

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Navigating Medicare: Your Rights and Options

Understand the ins and outs of Medicare, your entitlements, and how to cover out-of-pocket costs. Learn about the basics of Medicare, your enrollment options, and the importance of timely enrollment. Discover the four parts of Medicare and the role of Medigap insurance.

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Seniors' Experiences with Medicare Marketing and Fraud

During Medicare open enrollment, seniors age 65 and older receive numerous solicitations about plan choices through phone calls, mailings, emails, and advertisements. The frequency of these marketing efforts varies, with some seniors reporting misleading information and fraudulent practices by marke

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Can Medicare Beneficiaries Afford Their Health Care? Findings from Commonwealth Fund 2023

Americans with Medicare face challenges affording health care, with many struggling to pay for essential health services. The Commonwealth Fund 2023 survey reveals that a significant portion of Medicare beneficiaries find it difficult to afford health care costs, leading to delays in necessary care

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Referrals, Advocacy and Reimbursement for DSMES

Explore the critical aspects of referrals, advocacy, and reimbursement for Diabetes Self-Management and Support (DSMES) with insights from Joan Bardsley. Gain knowledge on aligning DSMES with type 2 diabetes care standards, appealing denied Medicare claims, and understanding Medicare policy challeng

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Office of the Ombudsman for EEOICPA: Role and Responsibilities

The Office of the Ombudsman for EEOICPA plays a crucial role in providing information, guidance, and assistance to claimants under the Energy Employees Occupational Illness Compensation Program. Established in 2004, the Ombudsman's office is independent and maintains confidentiality in its communica

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Evolution of Medicare and the Rise of Direct Contracting Entities

Explore the historical journey of Medicare from its inception to the introduction of Medicare Advantage and Direct Contracting Entities. Understand key acronyms, models, and initiatives shaping the current healthcare landscape, and delve into strategies to address challenges posed by the shift towar

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Medicare Prescription & Outpatient Drugs Data Analysis October 2022

Enrollment in Medicare stand-alone prescription drug plans slightly declined between 2020 and 2021. The rates of enrollment vary between rural and urban states, with higher enrollment in rural states with low Medicare Advantage rates. Across counties, enrollment in prescription drug plans ranges fro

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Important Updates on the New Medicare Card Project

The New Medicare Card Project is nearing completion, with significant changes coming into effect from January 1, 2020. Beneficiaries are advised to use their new Medicare cards, protect their Medicare number, and take necessary steps to ensure smooth transitions. Key points reinforce the importance

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Speech Therapy Guidelines and Medicare Regulations Overview

This content provides detailed information on writing person-centered functional goals in speech therapy, emphasizing SMART goals and best practices. It covers course descriptions, objectives, and Medicare regulations related to speech therapy services. The importance of reasonable and necessary evi

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Understanding Retirement Benefits: Social Security and Medicare Overview

This content provides valuable information from an open forum on retirement benefits, covering topics such as Social Security, Medicare, and what happens to benefits when leaving a job. It includes details on Social Security retirement benefits based on age, statements, contact info, and an overview

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Medicare Physician Fee Schedule Proposal for CY2023 Provisions

The Medicare Physician Fee Schedule (PFS) outlines the payment framework for Medicare Part B services. Each year, CMS proposes changes in an NPRM, allowing stakeholders to comment. Key aspects include telehealth extensions and flexibilities during COVID-19. The PFS rulemaking process leads to final

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Scott Joyce: Your Go-To Expert for Medicare 101 in St. Louis

Medicare 101 St. Louis, is a comprehensive introduction to the Medicare program, designed to educate you on the various parts of Medicare, including Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (pr

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Overview of ACL: New State Ombudsman Orientation Insights

Explore insights from the ACL Louise Ryan State LTC Ombudsman Conference, covering NORS basics, administration details, ACL mission, leadership, and tips on effectively using the National Ombudsman Reporting System (NORS) for data collection and reporting.

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Serving Small Businesses and Entrepreneurs: Office of the National Ombudsman

The Office of the National Ombudsman, created under the Small Business Regulatory Enforcement Fairness Act of 1996, acts as a mediator between small businesses and federal agencies, addressing concerns about regulatory enforcement. Encouraging regulators to prioritize compliance assistance over pena

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Understanding the Role of Ombudsman in Minnesota's Human Services

An exploration of the role of Ombudsman in Minnesota, focusing on the functions and responsibilities of the Office of Ombudsman for Mental Health and Developmental Disabilities. Learn about the mission, people served, and the definition of an agency, facility, or program in relation to mental health

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Overview of U.S. Prescription Drug Spending and Medicare Part D

U.S. prescription drug spending data from 2005 to 2025 shows trends in various payer contributions, with predictions for future years. Medicare Part D's drug spending is broken down, revealing top drugs and rebate percentages. The total Medicare spending in 2015 and average annual growth in Medicare

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Understanding Medicare Prescription Drug Coverage

The material provides comprehensive information on Medicare prescription drug coverage, including the basics, benefits, costs, eligibility, enrollment, extra help, plan comparisons, coverage determinations, and appeals. It covers the four parts of Medicare and explains the requirements and processes

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Prescription Drug Coverage in Medicare Enrollees with Chronic Kidney Disease

This report delves into the sources and parameters of prescription drug coverage in Medicare enrollees with chronic kidney disease (CKD) for the years 2010 to 2015. It explores the trends in Medicare Part D enrollment, out-of-pocket costs, and catastrophic coverage benefits. The data presented sheds

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DePauw University Medicare Benefits Program Overview

This presentation details the DePauw University Medical & Rx Benefits Program for Medicare retirees, presented by Justin Goodwin from Amwins Group Benefits. It covers the agenda for the day, introduction to the program, information about Amwins Group Benefits, DePauw University's role in the Medicar

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Navigating Medicare and Employer Insurance Overlap

Individuals near Medicare eligibility while working or retired often seek HR guidance. However, HR may lack expertise on Medicare interaction, leading to gaps in coverage, penalties, and limitations. To avoid these issues, it's crucial to understand the client's employment status, Medicare eligibili

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Comprehensive Overview of CompanionCare Medicare Supplement Plan

Explore the benefits and coverage provided by the CompanionCare Medicare Supplement Plan effective January 1, 2021. Learn about the plan's offerings, enrollment criteria, and details on Medicare co-pays, coinsurance, and out-of-pocket expenses. Gain insights into who is eligible, moving to Companion

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Understanding Medicare Coverage and Benefits for 2022

Explore key aspects of Medicare including eligibility, coverage, costs, and additional options for more coverage. Get insights on Medicare Part D, what Medicare covers, and what it doesn't. Find details on benefit decisions for individuals aged 65 and above, actively working retirees, and surviving

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The Impact of Retiree Health Costs on Medicare and Medicaid Programs

This content discusses how retiree health costs affect individuals and government programs, specifically focusing on the rising Medicare and Medicaid spending projections. It highlights the challenges posed by out-of-pocket expenses for retirees and the gaps in Medicare coverage that contribute to h

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Understanding Medicare Reimbursement and Inpatient Services in Short Stay Acute Care Facilities

Short stay acute care facilities, also known as hospitals, play a critical role in delivering inpatient and outpatient services to patients. Understanding Medicare reimbursement policies, such as billing for Medicare Part A (IPPS) for inpatient services and Medicare Part B (OPPS) for outpatient serv

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Understanding Medicare Advantage Plans - Overview & Benefits

Dive into the comprehensive overview of Medicare Advantage Plans, covering the history of Medicare, Medicare ABCDs, enrollment periods, service areas, and product details for 2022. Learn about the different parts of Medicare, including Part A which covers inpatient care, Part B for physician service

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UnitedHealthcare Expands Medicare Solutions in More Counties for 2022

UnitedHealthcare is increasing its coverage in Medicare Advantage and DSNP plans, aiming to serve more consumers in various counties for 2022. This expansion will provide eligible individuals with more options and access to quality healthcare coverage. The growth in both Medicare Advantage and DSNP

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Medicare Beneficiary Identification Initiative Overview

The Social Security Number Removal Initiative (SSNRI) aims to enhance Medicare beneficiary protection by replacing SSN-based Health Insurance Claim Numbers with new Medicare Beneficiary Identifiers (MBIs). This initiative mandates the issuance of redesigned Medicare cards by April 2019, minimizing i

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Office of the Ombudsman for Energy Employees Occupational Illness Compensation Act

The Office of the Ombudsman for the Energy Employees Occupational Illness Compensation Act (EEOICPA) in Cullman, AL held outreach meetings in November 2019. They provided information on benefits, resources, and assistance related to EEOICPA claims. The Ombudsman's duties include making recommendatio

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Enhancing NORS Reporting Through Ombudsman Activities Training

This webinar conducted in March 2012 focused on improving consistency in NORS reporting by providing clarification on activities required to be reported to AoA. Key aspects covered included reviewing AoA definitions, activities, measures, and coding scenarios. Initial comments from notable figures i

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Understanding Indirect Tax Ombudsman Duties and Responsibilities

Explore the origins and significance of the institution of Ombudsman, with a focus on the Indirect Tax Ombudsman's role in resolving public grievances related to Customs, Central Excise, and Service Tax departments. Learn about the standards in public life and the global adoption of Ombudsman instit

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Understanding the Role of Medicare Beneficiary Ombudsman

Explore the vital role of the Medicare Beneficiary Ombudsman in addressing beneficiary inquiries, providing education, and recommending improvements in Medicare administration. Discover when to contact the Ombudsman for systemic issues, research topics, or feedback on Medicare experiences, including

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Handling Medicare Set-Asides: Key Considerations and Compliance Updates

This comprehensive guide covers essential aspects of managing Medicare Set-Asides, including eligibility criteria, confirming Medicare status, compliance with the Medicare Secondary Payer Act, potential penalties for errors in reporting, and strategies to avoid violating the MSP statute. Stay inform

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Understanding Medicare: A Guided Tour for Beneficiaries

Explore Medicare eligibility, enrollment, benefits, and more in this comprehensive program designed for beneficiaries, advocates, and curious citizens. Get informed, engage effectively, and seek expert help to navigate the Medicare system with confidence. Join us on December 5, 2023, for a guided to

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Understanding Medicare: Coverage Options and Enrollment Details

Medicare is a federal health insurance program catering to individuals aged 65 and older, those with certain disabilities, end-stage renal disease, or ALS. It offers different coverage options including Part C Medicare Advantage Plans. Enrollment details, premiums, and benefits such as hospital insu

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Volunteer Ombudsman Program for Risk Management: Empowering Advocacy in Long-Term Care

Iowa's Office of the State Long-Term Care Ombudsman oversees the Volunteer Ombudsman Program (VOP), dedicated to safeguarding the health, safety, welfare, and rights of long-term care residents. The program investigates complaints, seeks resolutions, and advocates for quality of life enhancements. V

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Revamping Medicare Card System for Improved Security

The Medicare Access and CHIP Reauthorization Act of 2015 initiated a project to replace Social Security Number-based Health Insurance Claim Numbers with unique Medicare Beneficiary Identifiers. The primary goal is to reduce beneficiary vulnerability to identity theft. The project involves operationa

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