Medicare Claims Analysts
“Medical Necessity” is a term that has been used in recent years by Medicare and may not be familiar to you. “Medical Necessity” means that there are procedures and services physicians may prescribe for you that they may feel are necessary to manage your health. However, Medicare may not pay for certain services based up on their policies.
In the past, Medicare has covered most procedures. With the emergence of MRI, CT Scan, and other sophisticated and costly services and procedures as the diagnostic methods of choice, it is important for you to know what procedures and services will be covered by asking your physicians and or Medicare. We also encourage you to discuss with your physicians other treatment options available to you that may give them the information that they need to treat you. If your physician orders a procedure or service that Medicare may not cover, you may be asked to sign an Advance Beneficiary Notice (ABN). The ABN informs you in advance that Medicare is not likely to pay for the procedure or service, and that you will be responsible for payment. By signing the ABN, you are indicating that you understand and agree to be personally and fully responsible for payment.
Medicare beneficiaries are responsible for deductibles and co-insurance. If you receive services as an outpatient or in outpatient observation, you will be billed for non-covered oral drugs and some injectable drugs that fall under the category of Self-Administered. Please refer to the online version of National Medicare Handbook at www.medicare.gov or call 1-800-633-4227 if you need more information.
Do You Have Any Options?
You can agree to be financially responsible for the procedure by signing the ABN form, or you can refuse the test or services. If you refuse the test or services, you will also be asked to sign a form indicating you’ve elected not to have the service. If you request the services and will not sign the ABN, you will still be responsible for payment. If you need services that are not covered by Medicare, you will be responsible for payment. You have the right to appeal a Medicare decision not in your favor. If you would like to appeal a Medicare decision, or have other Medicare questions, please contact the Medicare beneficiary hotline at 800-633-4227.
Lenoir Memorial Board votes to pursue strategic partnership with Novant Health
After a yearlong selection process for a strategic partner, the Lenoir Memorial Board of Directors has unanimously voted to pursue a partnership through a management agreement with Novant Health, hospital officials announced today. The decision follows a thorough search and exploration process led by the board to select a partner who would best position Lenoir Memorial for the future of healthcare and create a stronger health system for the Kinston community. "For more than a century, Kinston has had a community hospital and the chapter we're beginning today will preserve that legacy of local healthcare for future generations," said Gary Black, president and CEO of Lenoir Memorial. "Through an affiliation with Novant Health, we will further enhance the services we provide, ensuring that high-quality care remains close to home." The Lenoir Memorial Board now enters discussions with Novant Health to structure the terms of the partnership, leading to the signing of the management agreement, which the board hopes to finalize this spring.LEARN MORE
Affordable Care Act and Healthcare Marketplace
Lenoir Memorial plays a vital role in educating uninsured patients about their coverage options and helping them navigate the Marketplace. There are several ways to apply for health coverage. You can apply online using a laptop or desktop computer. (You may not be able to complete the application using a smartphone or tablet.) You can also fill out a paper application, apply over the telephone or apply in person at certain sites. Find out more about the different ways to apply here. Certified Application Counselors (CAC) are available within Lenoir Memorial to educate consumers and aid them in completing an application for coverage. If you have questions or wish to set up an appointment, you may contact Terrence Body, social worker at 252-522-7977, a patient accounts counselor at 252-522-7000 or call 800-318-8596 at any time of day, seven days a week. Or visit HealthCare.gov.LEARN MORE
HealthLink - Winter 2015
Check out the latest edition of Lenoir HealthLink! Download the pdfLEARN MORE
HealthLink - Fall 2014
Check out the latest edition of Lenoir HealthLink! Download the pdf.LEARN MORE
Health Needs Assessment
Lenoir County Health Department and Lenoir Memorial Hospital are conducting a county-wide health assessment. Your opinions about our community are important to us. Please complete the 2014 Community Health Assessment survey located at this link https;//docs.google.com/forms/d/1aAOrM2yYy9LUs7uhbpQY8H3Ckxdizx6xL7dG02zRjw0/viewform?usp=send_form
Get Your Rear In Gear - November 5
This free colorectal screening clinic is for men & women age 40 and up who have never been screened for or had colorectal cancer. The clinic will be led by members of the WellAare team and the Lenoir Memorial Gastro staff. This screening is funded in part by a grant from Get Your Rear in Gear - Kinston and the Lenoir Memorial Foundation. Call 522-7014 to complete required registration.LEARN MORE
Get Your Rear In Gear - Sept 10
This free colorectal cancer screening clinic is free for men and women age 40 and up who have never been screened for or had colorectal cancer. The clinic will be led by members of the WellAware team and the Lenoir Memorial Gastro staff. This screening is funded in part by a grant from Get Your Rear In Gear-Kinston and the Lenoir Memorial Foundation. Call 522-7014 to complete the required registration.LEARN MORE
Get Your Rear in Gear! - June 4
This free colorectal cancer screening clinic is for men & women age 40 and up who have never been screen for or had colorectal cancer. The clinic will be led by members of the WellAware team and the Lenoir Memorial Gastro staff. This screening is funded in part by a grant from Get Your Rear In Gear - Kinston and the Lenoir Memorial Foundation. Call 522-7014 to complete the required registration. Lenoir Memorial Neuse Room is located on the lower level of the hospital and easily accessible through the Minges Wellness Center entrance.LEARN MORE
Quit for Life Tobacco Cessation Program
Class sizes are limited and classes start promptly at the appointed time. Each class is one hour long. Class are available at 8:30 - 9:30 or 3:30 - 4:30 on days listed below. Registration must be done by calling 252-522-7014. Dates for 2015 are as follows:
HealthyLife Weigh - May
This weight management program focuses on weight loss goals supported by healthier nutrition practices and increased physical activity. It is ideal for the individual needing to lose 10-40 pounds, and ready to commit to lifestyle changes. Nutrition education is delivered in a 4 week program led by a registered dietitian in the Minges Wellness Center at Lenoir Memorial. The program is a modified form of the national program, HealthyLife Weigh, and focuses on the necessary formula for permanent weight loss: balancing calorie intake from food and calorie output through physcial activity. We will assist you in making permanent lifestyle changes to help you get to and stay at a healthy body weight. This is not a diet but a new way of incorporating positive eating and activity habits. The cost is $150. Participants will receive two months membership in the Minges Wellness Center with an individual exercise plan develped with an exercise specialist.LEARN MORE