qUick reads: The Deductible Game

CMS released their annual update to Beneficiary premium, copay, and deductible rates for 2018. Here’s what we learned:

  • Copay continues to be 20%.
  • 2018 Deductible amount will continue to be $183.00 a year, same as last year.
  • NOTEWORTHY: Deductibles will be applied broken up over two months, instead of one lump sum.

  What does that mean for you in HDMS? Nothing changes. We recommend that you verify insurance and record the information in patient demographics before each service or sale. Based on your eligibility check, we’d recommend that you only indicate “deductible is met” when eligibility verifies that the full $183.00 has been spent. An indication that the deductible "is met" is for informational purposes only.   What does that mean for you as a Provider? Your initial charge to Medicare this year may receive a response that contains both deductible AND payment amounts. If the expected allowable is over $126.88, it’s possible that they will apply that amount to deductible, and pay out the difference. Don’t worry…Medicare will get the remaining $56.12 of deductible on next month’s claim.   Source: MLN Matters Number: MM10405 #likeabiller