OTHER REPORTS

 Credit Balance Reports 

 Due 30 days after the end of each fiscal quarter 

 Report over-payments from Medicare 

 No payments will be made if you do not complete this report 

 CMS billing audit reports 

 CMS may ask for 25 patients specific billing for a date of service and the office notes to support the billing. 

 An adjudicator reviews and decides if the service was a medical necessity. 

 Monies can be taken back by Medicare. There is an appeal process through the adjudicator.

Gathering important information

Start by helping the person you’re caring for gather this information so it’s available when you need it:

• Social Security Number 

• Medicare number (You can find this on his or her red, white, and blue Medicare card.) 

• Medicare plan enrollment (See pages 13–14 for information on how to check his or her current coverage.)

• Other insurance plans and policy numbers, including long-term care insurance 

• Contact information for health care providers, like doctors, nurses, hospitals, pharmacies, and medical suppliers 

• List of current prescription drugs and dosages 

• Current health conditions, symptoms, and treatments 

• History of past health problems 

• Allergies or food restrictions

• Emergency contacts, like close friends, family, neighbors, clergy, or housing manager

• Financial and legal information

Next steps 

For help keeping track of this information: 

• Visit MyMedicare.gov to help the person you’re caring for get personalized information about his or her Medicare benefits and services, like plan enrollment, claims, and more. See pages 42–43 for more information.

Planning for future health care decisions 

Ask the person you’re caring for to share information about his or her doctors, medicines, and medical history. Knowing this information will better enable you to help him or her plan for health care and prescription drug needs. It’s also important to encourage the person to decide who should have the legal right to make medical and treatment decisions if he or she is unable. Talk to the person you’re caring for about what he or she wants and doesn’t want you to do. He or she may want to choose and authorize someone to make decisions about his or her medical care. These decisions are generally called advance directives. Note: Before Medicare will give personal health information to you, the person you’re caring for has to let Medicare know in writing. If you plan on contacting Medicare, it would be a good idea for the person you’re caring for to fill out a “Medicare Authorization to Disclose Personal Health Information” form.