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PROVIDER QUICK TIPS Medicare Dual Eligible Claims with Duplicate CAR (Claim Adjustment Reason Code) CO 237 Medical Assistance (MA) confirmed in February and March 2015 new practices undertaken by

How to fill out medicare dual eligible claims

How to fill out medicare dual eligible claims

1. Gather all necessary information and documents such as the patient's Medicare and Medicaid cards, medical records, and any other relevant documents.
2. Ensure that you have the correct CMS-1500 claim form for Medicare claims and the appropriate Medicaid claim form.
3. Fill out the patient's personal information on the claim form, including their name, address, date of birth, and Social Security number.
4. Provide the necessary information about the medical services or supplies being claimed, such as the date of service, diagnosis codes, procedure codes, and any supporting documentation.
5. Indicate on the form that the claim is for a dual eligible patient by checking the appropriate box or coding.
6. Include any other required information or attachments, such as a copy of the Medicare Summary Notice (MSN) or Explanation of Benefits (EOB).
7. Double-check all the information for accuracy and completeness before submitting the claim.
8. Submit the completed claim form to the appropriate Medicare and Medicaid claims processing entities based on the patient's state and program eligibility.
9. Follow up on the claim to ensure it is processed correctly and that the patient receives the eligible benefits from both Medicare and Medicaid.

Who needs medicare dual eligible claims?

1. Individuals who are eligible for both Medicare and Medicaid are the ones who need Medicare dual eligible claims.
2. Medicare dual eligible claims are typically for individuals with limited income and resources who qualify for assistance from both programs.
3. These individuals usually have coverage for a wide range of healthcare services and prescription drugs through their dual eligibility status.
4. Medicare dual eligible claims help ensure that these individuals receive the maximum benefits and cost savings available to them from both Medicare and Medicaid.
5. It is important for healthcare providers and caregivers to understand the process of filling out and submitting Medicare dual eligible claims to support the needs of these individuals.

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What is medicare dual eligible claims?

Medicare dual eligible claims are claims filed for individuals who are eligible for both Medicare and Medicaid benefits.

Who is required to file medicare dual eligible claims?

Health care providers who provide services to individuals eligible for both Medicare and Medicaid benefits are required to file medicare dual eligible claims.

How to fill out medicare dual eligible claims?

Medicare dual eligible claims can be filled out online through the CMS' Medicare dual Eligible claims system or through third-party billing services.

What is the purpose of medicare dual eligible claims?

The purpose of medicare dual eligible claims is to ensure that individuals eligible for both Medicare and Medicaid benefits receive the appropriate coverage and services.

What information must be reported on medicare dual eligible claims?

Medicare dual eligible claims must include information such as the patient's Medicare and Medicaid ID numbers, services provided, and billing codes.