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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Delve into the intricacies of OIG reviews of trauma payment claims, focusing on the potential impact on Medicare payments for trauma centers and providers. Learn about key issues investigated by the OIG, such as non-designated/verified trauma centers, using revenue codes, trauma team upgrades/downgr

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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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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 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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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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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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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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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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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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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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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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Learn how to effectively utilize VBMS for managing veteran claims, including accessing claims, locating rating decisions, tracking claims, and bookmarking files. This comprehensive guide covers logging in, accessing all claims, searching for veterans, accessing file functions, managing flashes, revi

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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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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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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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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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Understanding the concepts of claims, evidence, and warrants is crucial for constructing persuasive arguments. Claims represent positions to persuade, evidence supports claims with facts, and warrants bridge the gap between evidence and claims. An exercise is outlined to help practice forming claims

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The Consumer Rights Act 2015 introduced a new regime for competition damages claims, allowing for stand-alone and follow-on claims. However, limitations periods under the new regime, specifically Section 47E CA, apply only to claims arising after 1 October 2015. The CAT Rules play a crucial role in

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Discover strategies to enhance healthcare claims scrutiny, minimize errors, and ensure accurate payments for genuine claims. Optimize your claims process with proven techniques.

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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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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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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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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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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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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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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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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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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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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 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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Californians who died in 2014 were analyzed in terms of Medicare coverage, spending at the end of life, and hospice care utilization. The data shows a decrease in the share of total Medicare spending, variations in spending with age, and an increase in hospice use and spending over the years. Furthe

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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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The language of advertising claims, as explored by Jeffrey Schrank, delves into how ads make assertions about product superiority. It discusses misleading versus true claims, the prevalence of pseudo-information for parity products, and various types of claims like Weasel, Water is Wet, Unfinished,

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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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Risk adjustment fraud in Medicare Advantage involves upcoding for diagnosis codes, leading to fraudulent claims. This scheme impacts the payment system by inflating costs through false diagnoses. By exploiting the capitated payment model, some organizations may engage in activities that potentially

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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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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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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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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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