Topic: Medicare
Services provided by PACE
Eligibility Requirements for PACE
If there are any issues with the Buy-In, look over the following items to verify that they are correct on the case: Certification period 12 months Claim number on Bendex (Block B07) Medicare cards are now issued with a new Medicare number that is unique to the beneficiary instead of using SSN-based Health Insurance Claim […]
Information regarding Third Party Liability (TPL) needs to be coded on the TPL tab in FACS so that the Oklahoma Health Care Authority (OHCA) can make sure the private insurance covers their part before OHCA pays anything on a bill. Make a copy of the insurance card so the information from that card can be […]
Description of the parts of Medicare and where to find more information about Medicare
MMIS stands for: Medicaid Management Information System. It is used to verify eligibility for medical programs. Access MMIS Extranet from your desktop or from the InfoNet. Refer to article: How Do I Access MMIS Extranet from the InfoNet? On the initial screen of MMIS Extranet Page, click Eligibility Select from 4 options to look up […]
State/Agency Part A (HI) Code Part B (SMI) Code Alabama S01 010 Alaska S02 020 Arizona S03 030 Arkansas S04 040 California S05 050 Colorado S06 060 Connecticut S07 070 Delaware, Public Assistance S08 080 District of Columbia S09 090 Florida S10 100 Georgia S11 110 Guam N/A 650 Hawaii S12 120 Idaho S13 130 […]
The following BENDEX Income codes provide additional details regarding income. B21 Date Initial Entitlement B22 Current Entitlement Date B23 Entitlement Effective Date B24 Retro Payment Amount B25 Direct Deposit Indicator B26 – Payment Cycle Indicator Indicates when the benefit check was released 3RD = 3rd of the month 2WED = 2nd Wednesday 3WED = 3rd […]
Specified Low-Income Medicare Beneficiaries (SLMB) – means individuals who, except for income, meet all of the eligibility requirements for QMBP eligibility and are enrolled in Medicare Part A. When approved for SLMB, Medicaid pays for the Medicare Part B premium. Policy regarding this term is located at: Public Assistance Procedures (SoonerCare): 340:65-3-1. Determination of eligibility; […]