Understanding Dual Eligible Patients: Billing Rules for Medicare and Medicaid

This webinar focuses on understanding dual eligible patients and the specific billing rules for those covered by both Medicare and Medicaid. As a Medicare provider, it is crucial to be aware of the statutory requirements regarding what can and cannot be collected from these dually eligible patients. Participants will learn the essential rules and statutes governing billing for Medicare and Medicaid patients and gain practical language and communication strategies to effectively explain these complex regulations to patients.

• -Identify the key characteristics of dual eligible patients and their coverage under both Medicare and Medicaid
• -Explain the primary payer rules and how Medicare and Medicaid coordinate benefits for dual eligible beneficiaries
• -Apply statutory requirements regarding allowable collections from dual eligible patients, including cost-sharing limitations
• -Recognize prohibited billing practices and potential compliance violations when treating dual eligible patients
• -Develop effective patient communication strategies to explain complex billing rules in clear, understandable language
• -Implement practical documentation and billing procedures to ensure compliance with Medicare and Medicaid regulations