A. Medicare Program Information

World of Medicare Web-Based Training

This course introduces the Medicare Program, including its purpose and history, coverage, CMS and contractor roles, and the claims handling process. Beneficiary-related topics such as eligibility and benefit options are also covered.
www.cms.hhs.gov/MLNProducts/03_WebBasedTraining.asp

Medicare Physician Guide: A Resource for Residents, Practicing Physicians, and Other Health Care Professionals

This guide offers general information about the Medicare Program, becoming a Medicare provider or supplier, Medicare payment policies, Medicare reimbursement, evaluation and management documentation, protecting the Medicare Trust Fund, inquiries, overpayments, and appeals.
www.cms.hhs.gov/MLNProducts/MPUB/itemdetail.asp?filterType=keyword&filterValue=residents&filterByDID=0&sortByDID=1&sortOrder=ascending&itemID=CMS061390

Front Office and Medicare Web-Based Training

The patient registration process and front office tasks are vital for successful Medicare claims filing. This course teaches the important steps front office staff should take in gathering patient information for Medicare claims processing. It also explains the importance of obtaining accurate information.
www.cms.hhs.gov/MLNProducts/03_WebBasedTraining.asp

Collecting, Submitting, and Updating Beneficiary Insurance Information to Medicare, Fact Sheet for Physician and Provider Billing Staff

This fact sheet provides a general overview of the Medicare Secondary Program (MSP) for individuals involved in the admission and billing procedures at physician's offices and other provider settings. Topics include a definition of Medicare Secondary Payer (MSP), benefit to providers, MSP requirements, determining who pays first, a definition of Medicare Coordination of Benefits (COB), and how to contact the COB contractor.
www.cms.hhs.gov/MLNProducts/downloads/MSP_3a.pdf

Fast Fact:

The term Medicare Secondary Payer (MSP) is the term used by Medicare when Medicare is not responsible for paying a claim first. When Medicare began in 1966, it was the primary payer for most beneficiaries. In 1980 changes were made to Medicare laws which increased the number of coverage and benefit programs that are responsible for paying a claim first. With the increase in additional insurance plans and payment programs that pay the claim before Medicare does, the provider's responsibility to maintain accurate, up-to-date information about Medicare beneficiaries is critical.

Medicare-Medicaid Relationship Brochure

This brochure offers an overview of Medicaid and of the relationship between Medicaid and Medicare.
www.cms.hhs.gov/MLNProducts/downloads/Relationship_Brochure.pdf

Medicare Modernization Update Web Page

This web page contains a summary of the Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) and its provisions.
www.cms.hhs.gov/MMAUpdate/01_Overview.asp

Medicare General Information, Eligibility, and Entitlement Manual

A general overview of the Medicare Program is provided in this manual, along with responsibilities for Medicare providers and contractors. Medicare covered and noncovered services are listed, as well as important Medicare Program definitions. The manual also covers Part A deductibles and Part B coinsurance information and the importance of physician certification within the Medicare Program.
www.cms.hhs.gov/Manuals/IOM/itemdetail.asp?filterType=keyword&filterValue=eligibility&filterByDID=0&sortByDID=1&sortOrder=ascending&itemID=CMS050111

History Web Page

This web page offers a brief history of the inception of the Medicare Program and its changes.
www.cms.hhs.gov/History

Fast Fact:

On December 8, 2003, President Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003 (Pub. L. 108-173). This landmark legislation provides seniors and individuals with disabilities with a prescription drug benefit, more choices, and better benefits under Medicare.