Here’s a fun fact that is wreaking havoc in practices with a large volume of patients over 65, especially where facility work (SNFs, assisted living, nursing homes) is involved: Enrollment in Medicare Advantage Plans has DOUBLED over the past decade
It has been reported so far in 2021 that approximately 43% (up from 39% in 2020; see graph below) of the 63 million individuals who “have Medicare” actually receive their benefits via an Advantage Plan. And just when you thought you were finished updating patient insurance information in January and February, if those Medicare Advantage patients decide that the plan they chose was not the right fit and they want to go back to traditional Medicare, they have until March 31st to do so.
“If a patient refuses to pay their bill due to a high deductible, is it possible to request the insurance company (i.e. Anthem) to delete the claim? That way, the patient will still be responsible for paying their deductible amount elsewhere.”
“I have great difficulty getting paid for CPT 28308 when a hammer toe repair is performed at the same time. The billing scenario generally will look like this:
CPT 28308 (2nd metatarsal osteotomy) -RT
CPT 28285 (2nd hammertoe repair) -T1 -59
We never get paid for CPT 28308 in this scenario. Does anyone have any suggestions? We link the acquired deformity of bone diagnosis to CPT 28308.”
