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Breakthrough Changes in Improper Billing of QMBs-What Advocates Need to Know

September 7, 2017

When: Monday, October 2, 2017 at 11:00 a.m. PT/ 2:00 p.m. ET.

Medicare providers are prohibited from billing Qualified Medicare Beneficiaries (QMBs) for any Medicare co-payments or deductibles. This includes most dual eligibles. However, the problem of improper billing persists.

A significant change in Medicare Summary Notices (MSNs) and in provider remittance notices starts in October. The change is designed to give QMBs more protection from bills that they should not have to pay and help providers determine who should not be billed. The revised MSNs will show that the QMB’s payment responsibility is zero for each Medicare-covered service and denote that the zero cost is due to the individual’s QMB status. Remittance notices to providers will also show that no remaining amount is due from the beneficiary, and eligibility query systems will provide clear information on a patient’s QMB status. The notices are meant to make it easier for both providers and consumers to understand payment responsibilities.

This free webinar, Breakthrough Changes in Improper Billing of QMBs—What Advocates Need to Know, explains the changes in detail. The webinar is co-sponsored by NCOA Center for Benefits Access. It will include:

  • a general overview of improper billing,
  • help for advocates and counselors understand how to interpret the revised MSNs,
  • how to understand what provider billing offices see, and
  • tips and resources if your client continues to receive improper bills.

Kim Glaun, Medicare-Medicaid Coordination Office, Centers for Medicare and Medicaid Services
Georgia Burke, Directing Attorney, Justice in Aging
Denny Chan, Staff Attorney, Justice in Aging

The webinar took place on Monday, October 2, 2017 at 11:00 a.m. PT / 2:00 p.m. ET.

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