medicare/coupon proper billing Qs

[spoon714]

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Can someone educate me about coupons and Medicare billing. I'm a bit confused on how it works since I'm new with dealing with insurance. Pharmacist too busy, didn't want to bug.There is the red white and blue card which is medicare B for immunizations-OMN. Patients Also bring cards that says for example:Humana medicare rx and sometimes Humana hmo. It looks like insurance companies offer medicare coverage thru the plans, so that means it's probably government funded and therefore cannot use any manufacturers coupon to bill fully or partially, is that correct? If someone could verify that, thanks

So in a blanket statment, if the computer system or their id card says medicaid or medicare rx, (humana medicare , bcbs medicare)it's funded by goverment and therefore cannot use coupons unless mentioned in the fine print. If it's commercial , coupon is fine.

What about diabetic supplies like strips? All the required information,codes specific directions and name..etc that's only for medicare B (red white and blue card) not medicare D-(Humana medicare)? Appreciate all the help.

 

[zelman]

Can someone educate me about coupons and Medicare billing. I'm a bit confused on how it works since I'm new with dealing with insurance. Pharmacist too busy, didn't want to bug.There is the red white and blue card which is medicare B for immunizations-OMN. Patients Also bring cards that says for example:Humana medicare rx and sometimes Humana hmo. It looks like insurance companies offer medicare coverage thru the plans, so that means it's probably government funded and therefore cannot use any manufacturers coupon to bill fully or partially, is that correct? If someone could verify that, thanks

So in a blanket statment, if the computer system or their id card says medicaid or medicare rx, (humana medicare , bcbs medicare)it's funded by goverment and therefore cannot use coupons unless mentioned in the fine print. If it's commercial , coupon is fine.

What about diabetic supplies like strips? All the required information,codes specific directions and name..etc that's only for medicare B (red white and blue card) not medicare D-(Humana medicare)? Appreciate all the help.

You are correct on everything, except maybe the last one. Most insurance policies require specific directions for diabetic testing supplies, so you want to make sure that you get that on all Rx's. However, if it isn't Part B, feel free to get a phone clarification (or have the RPh do so if required by state law) - you don't need a new Rx to be faxed.