Medical Billing Companies

Beneficiary Notices Initiative

The Medicare program allows the beneficiaries to receive formal notifications concerning the different benefits, denials and coverage status from the providers. The Advance Beneficiary Notices of Non-Coverage and Skilled Nursing Facility are also included along with these notifications. Previously the Congress has issued a law in 2015 called the Notice Act, which has made it compulsory for hospitals for issuing both written and oral notification for informing the patients. This would allow the patients to become well informed whether they are put under observation status, which is different from that being admitted as an in-patient in a hospital.

Technically, patients who spend more than a considerable amount of time in the hospital, like above 24 hours, are never admitted as in-patients. They are however, put under observation status of the outpatient category. The Medicare Outpatient Observation Notices (MOON) serves the purpose of attending to the concerns of such patients who are actually put in outpatient observation status but believe that they are in-patients. This will enable the patient to have an understanding regarding their status while availing a medical service.

Professional Medical Billing

Advance Beneficiary Notices

Depending on their status as in-patients or outpatients, most of the patients carry with the various financial responsibilities. This lack of clarity among patients regarding their status can significantly affect their ability to avail the necessary Medicare-covered placement within a Skilled Nursing Facility. Moreover, in-patients have specific services and benefits that are exclusively available to those admitted in the hospital. Whereas, outpatients clearly lack access to specialized services and benefits conferred to the in-patients. This is reflected in the fact that in-patient status for a certain amount of time is required for the patients to qualify for the various types of rehabilitation services offered.

CMS has come up with a new email address for any queries related to the Fee-For-Service Beneficiary Notice Initiative (BNI) notices, effective from April 13, 2017. The new email address of CMS BNI notices is BNImailbox@cms.hhs.gov. To carry out any inquiries by the members of the public concerning the MOON, the email address MOONMailbox@cms.hhs.gov, can be used.