If you accept Medicare or wish to work with Medicare in the future, then there are four main documents in which you should review and become familiar. We often receive inquiries regarding the information that can be found directly from these documents.
Working with Medicare can be daunting, but it doesn’t have to be! If you accept Medicare, be sure to check out the list below of all the compliance manuals necessary to run a successful ABC Accredited Facility. These manuals will also help you and your staff better manage the material. Think of this as your one-stop shop for Medicare Resources!
It may be less daunting to focus on one document per quarter. For example, your staff can focus on the claims and billing related documents/standards during the first half of the year, or perhaps you may find it more efficient for your compliance officer to review the documents and hold a quarterly staff meeting to address the material and relay the most pertinent findings to the group. Either method would allow for helpful training and keep your staff informed of Medicare’s requirements.
|Quarter||Manual or Resource||What is Covered|
|Q1||Medicare Program Integrity Manual||Your guide to assist with coding, billing and identifying/correcting any issues related to payments, claims, etc.|
|Q2||Medicare Claims Processing Manual||Manual to assist with billing and claims at your facility.|
|You should become familiar with this document as you are required to offer it to all Medicare patients. Many offer the abbreviated version for easier reading.|
|Q4||DMEPOS Quality Standards||These are required compliance standards for businesses as well as specific product requirements.|
We recommend that you bookmark these links at your office computers. That way, you can easily access them at any time and you will always be referencing the most current version of the documents (versus a paper copy that may become outdated).
Our Facilitator Medicare Corner is a great place to look for staff meeting discussion topics as it features various resources and educational materials in every issue. By identifying topics in advance, you can better train your staff to be equipped to handle the occasional Medicare woe and also inform your patients of their full Medicare benefits that they are likely to appreciate. At the end of the day, both your staff and patients will be better informed – win, win!