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.
Jonathan Anderson named PSEA of the Year
On February 25 a Lenoir Memorial's monthly Board of Director's dinner, Jonathan Anderson was named Presdient Service Excellence Award honoree for 2013. President and CEO Gary Black read the nominations of all the quarterly finalists and explained the nomination process to those present. "The PSEA program is one that allows anyone - peer, supervisor, or manager - the opportunity to recognized an employee for exemplary service. Annually, we recognized about three worthy employees each month. These PSEA recipients gather quarterly at a luncheon where the PSEA of the Quarter is named, resulting in four quarterly finaists from which one is chosen as PSEA of the Year. This year the four finalists were Janet Tilghman, Gail Avery, Jonathan Anderson, and Sever Johnson."LEARN MORE
Personal Wellness Profiles
Ready to make a change? Get started with your personal wellness profile. For only $40 and a few minutes of your time, you can discover ways to make personal changes that can lead to improved health. Now's your chance to get a personalized comprehensive report about your overall health and well-being. Simply complete a four-page questionaire and have blood drawn for a cholesterol panel and blood sugar test. You will receive an overall wellness score based on a number of health indicators, as well as recommendations for improving your health. Sign up for your two-session evaluation by calling Donna Potter, RN, at 252-522-7815.LEARN MORE
The Minges Wellness Center is pleased to announce our growing relationship with Healthways, an independent insurance benefit provider for Silver Sneakers and other fitness program benefits. As a local gym participating in Healthways Prime, and now Silver Sneakers, we look forward to working with older adults who have this benefit on their insurance plans. Bring your Silver Sneakers benefit card and sign up today! Call 252-522-7207 for more information.LEARN MORE
Lenoir Memorial hosts blog
Lenoir Memorial has established a blog site to keep the public informed about all the news at the hospital. Please check out our blog site at www.lenoirmemorialhospital.wordpress.com
Let’s Go to the Grocery Store - summer foods and grilling
Come stroll the aisles of the grocery store with our registered dietitian as we explore healthy and delicious options for you and your family. This session will focus on tips for tasty summer foods and grilling selections. Registration is required as group size is limited. For more information or to register, please call Angie Doncaster, RD,LDN, CDE at 252-522-7471.LEARN MORE
Don’t Burn in the Sun skin safety campaign
More than 1 in 5 Americans will develop skin cancer during their lifetimes!
Join us as we observe Skin Cancer Awareness in May by providing educational materials about skin safety and skin cancer detection and prevention. Free sunscreen samples will be provided to the first 50 participants. And you can register to win a summer safety gift basket valued at $100!LEARN MORE
Tangling With Tumultuous Teens - tips for parenting teens
Have teenagers? You may be wondering about some of the very same things that other parents wonder - is my teen normal? Why does my teen keep secrets from me? And what if I'm feeling a little crazed too? This presentation can help provide insight into parenting techniques and proven tricks of the trade in working with the older child who is struggling for independence and external pressures. Gain information about coaching for behavior in a changing world of excesses and peer pressure. You are not alone and you were once a youth too!LEARN MORE
Free Mammogram Screening - for high risk women
Women that qualify receive a free screening mammogram and education about breast self-exam. To qualify, you must be a woman between the ages of 40 - 65, have no insurance to cover mammograms, and never have had a mammogram. Preregistration is mandatory. call 252-522-7014 between 8 a.m. and 4 p.m. Monday - Friday to schedule your apointment time. This screening is sponsored by Lenoir Memorial Foundation and Eastern Radiologists, Inc.LEARN MORE
Asthma, Allergies and Air Quality
Asthma is chronic disease that affects the lungs. It is the most common chronic disease amoung children and a primary reason for school absences. Asthma can be controlled by avoiding the triggers that can cause an attck and using medicine. This interactive workshop will teach steps for avoiding or reducing asthma and allery triggers in both the indoor and outdoor environments. For more information about this workshop contact Neasha Graves at 919-966-3746 or email@example.comLEARN MORE