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The 2013 annual capitated allowed amount per beneficiary is 1900. Medicare will pay 80 of the allowed amount which will be 1520. If there is an underpayment of co-insurance you will owe us the difference. If there is an overpayment of co-insurance we will refund that amount to you. I have read and understand the above information regarding the Medicare rehabilitation services capitation and reimbursement regarding clinical supplies. Forms of payment Cash Check Visa MasterCard American Express...
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What is medicare form - acic?
Medicare form - ACIC stands for Annual Certification of Compliance with Medicare Secondary Payer Reporting Requirements.
Who is required to file medicare form - acic?
Entities that provide group health plan coverage to Medicare-eligible individuals are required to file Medicare form - ACIC.
How to fill out medicare form - acic?
Medicare form - ACIC can be filled out online through the Coordination of Benefits Secure Website (COBSW) provided by the Centers for Medicare & Medicaid Services (CMS).
What is the purpose of medicare form - acic?
The purpose of Medicare form - ACIC is to certify compliance with Medicare Secondary Payer (MSP) reporting requirements.
What information must be reported on medicare form - acic?
On Medicare form - ACIC, entities must report information related to group health plan coverage provided to Medicare-eligible individuals.
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