BC Advantage - 2012 Issue 4

Medicare Advantage Shadow Billing: Medicare Incentive Tips

This issue of IMA Insights seeks to provide a comprehensive discussion of how "shadow billing", by hospital providers, for their Medicare Advantage patients, can provide incentive payments to hospitals for the "meaningful use" of certified EHR technology.  "Shadow billing", synonymous with "no pay" or "information only" claims, is an unofficial term that refers to the process wherein hospitals submit claims to their Medicare Administrative Contractor (MAC) for inpatient services provided to Medicare beneficiaries who are enrolled in a Medicare Advantage (MA) plan. These claims are submitted, as per instructions from CMS through a series Transmittals, for the purpose...

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