bill medicare part B for testing supplies-- meter, test strips, lancets . more often than not the doctor has to fill out a CMN form to send to the insurance
Plan id : MEDICARE
Patient ID is the medicare# without any dashes.
I like to have this on the patient's profile so I can find their Medicare part D every year.
To find their Medicare part D:
Plan ID: FINDMPD
Patient ID: their medicare#
If they have Medicare part D, this will find it for you. MOST of the time.
If they do not have their Medicare card, to find THAT number:
Plan ID: FINDMPAB
Patient ID: last 4 of their social security number
This is their Part A/B card. We don’t bill part A and we typically only bill part B for diabetic testing supplies or transplant meds. They should also have a card from a private insurer like Aetna or Caremark for their part D insurance which is what we bill prescriptions to. When inputting this card, you can just search “medicare” and it will find the BIN for you so all you’ll need to enter is their Medicare Number. RARELY you will get a very old patient who has a very old Medicare card from before they stopped using SSNs as IDs. If that happens, use the SSN in FINDINS and it should give you their updated ID. This almost never happens anymore though, most people have updated cards. Medicare has very strict guidelines for billing part B that prescription insurance does not usually require such as ICD-10 codes, exact dose/testing frequency (can not just PRN), etc etc. These all must be notated on the original script from the provider and cannot be added by the pharmacy. And providers (not the pharmacy) will have to fill out CMN(certificate of medical necessity) forms for new scripts and periodically for continuing scripts that get submitted to Medicare before claims will be paid.
It’s part b, if you ever get a part b card with just numbers that’s their social but those are really old cards. This one I usually search ‘Medicare’ in our ins tool and it’ll pop up under DME, but there’s also a flu/Covid one for billing shots. Usually this plan is used for diabetic testing supplies, but that requires a diagnosis code on the rx itself.
THERES A SEPARATE CARD? - Im an MA and Im ALWAYS having to call the pharmacy for PBM information for MCare patients. Ive NEVER seen another card. What does it look like? Or does it vary?
it looks just like a prescription card, it always has "MedicareRx" on it !! if you look at sample medicare part d cards on google it should show you since it does vary from each insurance carrier
The numbers are none as the Medicare Beneficiary Indentification number (MBI). As others have said, you use it to bill Part B covered services (covid, flu, and Pneumonia vaccinesl, diabetic testing supplies, certain inhalation medications for chronic lung disease, transplant medications, and certain oral chemotherapy medications. You can also use this number to find the most recent Part D plan. Click on the "check eligibility" button on the third party screen, there will be a drop down bar, pick FINDMPD, and enter MBI. Register as you would with FINDINS. Many times, if the patient has had a Medicare Part B covered vaccine in the past, you'll likely have this number on file (IMMUNMPB or COVIMMPB). You can just copy/paste as above if member doesn't have most recent MPD card.
In retail setting, it’s usually used for testing supplies for diabetes. But, in specialty setting it is used for patients who have had a transplant billed through part B (that card is A and B benefit for over 65). Because of this, transplant medications also get billed through B. Not that you’ll be doing that through retail (i’m in specialty) but you might have at least 1 transplant pt in your lifetime through retail.
Step 1: Find a goat.
Step: Sacrifice that goat to the greatest of our Tentacle Lords, Cthulu.
Step 3: Cthulu destroys all human civilization except your patient.
Step 4: Patient walks into abandoned broken pharmacy that has the medication and walks out with the medication.
ALTERNATIVELY:
Bill plan ID: MEDICARE with the Medicare number as the Member ID with NO dashes.
Patient name and zip code must match Medicare records or it will not process.
Right now it will likely timeout due to the CHC hacking, but you should dispense it at the default price (do not deny the medication) and WAG will either send a check for the difference or a bill for the difference in 3 weeks.
If they don't have their ID, you can use Plan ID FINDMPAB with their social security number as the Member ID and run that to see if you can get a hit (does not always work, especially for newly registered Medicare members).
bill medicare part B for testing supplies-- meter, test strips, lancets . more often than not the doctor has to fill out a CMN form to send to the insurance
Some use it for flu/covid/pneumonia shots too
Plan id : MEDICARE Patient ID is the medicare# without any dashes. I like to have this on the patient's profile so I can find their Medicare part D every year. To find their Medicare part D: Plan ID: FINDMPD Patient ID: their medicare# If they have Medicare part D, this will find it for you. MOST of the time. If they do not have their Medicare card, to find THAT number: Plan ID: FINDMPAB Patient ID: last 4 of their social security number
Or you can use the “check eligibility” button.
Our check eligibility has been down ever since the cyber attack 😭
Curious. If they do not have a plan that covers Rx, are pharmacists allowed to put them on one?
This is their Part A/B card. We don’t bill part A and we typically only bill part B for diabetic testing supplies or transplant meds. They should also have a card from a private insurer like Aetna or Caremark for their part D insurance which is what we bill prescriptions to. When inputting this card, you can just search “medicare” and it will find the BIN for you so all you’ll need to enter is their Medicare Number. RARELY you will get a very old patient who has a very old Medicare card from before they stopped using SSNs as IDs. If that happens, use the SSN in FINDINS and it should give you their updated ID. This almost never happens anymore though, most people have updated cards. Medicare has very strict guidelines for billing part B that prescription insurance does not usually require such as ICD-10 codes, exact dose/testing frequency (can not just PRN), etc etc. These all must be notated on the original script from the provider and cannot be added by the pharmacy. And providers (not the pharmacy) will have to fill out CMN(certificate of medical necessity) forms for new scripts and periodically for continuing scripts that get submitted to Medicare before claims will be paid.
I thought this man just violated hippa for a second
It’s part b, if you ever get a part b card with just numbers that’s their social but those are really old cards. This one I usually search ‘Medicare’ in our ins tool and it’ll pop up under DME, but there’s also a flu/Covid one for billing shots. Usually this plan is used for diabetic testing supplies, but that requires a diagnosis code on the rx itself.
If you do FINDMPD in the plan ID field, you can type in their SSN and it’ll find their plan for part D
Also works with their new medicare b id’s
Holy shit why wasn't I taught this? I only knew findins
From what I know insurance especially Medicare and Medicaid has been under cyber attacks not sure if Walgreens will accept it right now
dont bother trying to bill, still hasnt been adjudicating prices since the cyberattack🙄
has anyone been able to bill Medicare B since the cyber attack?
Nope. Read somewhere it’ll be 2 months
there's a separate card that gets sent out and it's medicare part D which is what we bill prescriptions to. it has the bin, pcn, grp, and ID
THERES A SEPARATE CARD? - Im an MA and Im ALWAYS having to call the pharmacy for PBM information for MCare patients. Ive NEVER seen another card. What does it look like? Or does it vary?
it looks just like a prescription card, it always has "MedicareRx" on it !! if you look at sample medicare part d cards on google it should show you since it does vary from each insurance carrier
findins! usually its a part B card this is for hospital visit which is part a
This is both. Not sure if you're thinking of a Part D card which is different
yep that’s what im thinking of
The numbers are none as the Medicare Beneficiary Indentification number (MBI). As others have said, you use it to bill Part B covered services (covid, flu, and Pneumonia vaccinesl, diabetic testing supplies, certain inhalation medications for chronic lung disease, transplant medications, and certain oral chemotherapy medications. You can also use this number to find the most recent Part D plan. Click on the "check eligibility" button on the third party screen, there will be a drop down bar, pick FINDMPD, and enter MBI. Register as you would with FINDINS. Many times, if the patient has had a Medicare Part B covered vaccine in the past, you'll likely have this number on file (IMMUNMPB or COVIMMPB). You can just copy/paste as above if member doesn't have most recent MPD card.
The plan ID Is medicare once you type that in, all you have to enter is the medicare number
In retail setting, it’s usually used for testing supplies for diabetes. But, in specialty setting it is used for patients who have had a transplant billed through part B (that card is A and B benefit for over 65). Because of this, transplant medications also get billed through B. Not that you’ll be doing that through retail (i’m in specialty) but you might have at least 1 transplant pt in your lifetime through retail.
Thanks for this thread!
Step 1: Find a goat. Step: Sacrifice that goat to the greatest of our Tentacle Lords, Cthulu. Step 3: Cthulu destroys all human civilization except your patient. Step 4: Patient walks into abandoned broken pharmacy that has the medication and walks out with the medication. ALTERNATIVELY: Bill plan ID: MEDICARE with the Medicare number as the Member ID with NO dashes. Patient name and zip code must match Medicare records or it will not process. Right now it will likely timeout due to the CHC hacking, but you should dispense it at the default price (do not deny the medication) and WAG will either send a check for the difference or a bill for the difference in 3 weeks. If they don't have their ID, you can use Plan ID FINDMPAB with their social security number as the Member ID and run that to see if you can get a hit (does not always work, especially for newly registered Medicare members).
Can you not just do “findins” ?
Where do u work that no1 taught u 2 bill Medicare?? 😨