Medicare practices

Take Medicare without taking on the paperwork.

Plans of care certified by fax, secondary claims sent once the primary pays, the KX modifier added when a patient crosses the cap, Medicare Advantage caught before you bill — every Medicare rule, handled.

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Pause
Plan of care created
Faxed to the physician
Signed and returned
Certification active

PLAN OF CARE · P.01

X

Physician signature

CERTIFIED

 

How it works

Medicare requirements, remembered for you

Nobody chases the physician signature

Medicare pays the visit and checks later. An audit can reach back years and claw back what was never certified — so the plan of care faxes itself for signature, progress notes come due every tenth visit, and recertifications land before the current one lapses. The file holds up whenever someone asks for it.

Coming due

Plan of care certifiedSigned Jun 14
!Progress noteDue next visit
!RecertificationDue Sep 12

The other 20% gets billed on its own

Medicare pays 80%. The secondary claim waits for the remittance, then goes out with the exact balance — and whatever it doesn't cover goes to the card on file.

With a supplement

Medicare paid 80%$118.56
Supplement paid the rest$29.64
Nothing to collect$0.00

With a commercial secondary

Medicare paid 80%$118.56
Aetna paid part of it$24.40
Balance to the card on file$5.24

Never lose a line to a missing KX modifier

Past $2,410 of therapy in a year, Medicare rejects any line without the KX modifier on it. HealthSpark tracks the running total, tells you the moment a patient crosses, and adds the modifier from that visit on — you never have to watch the number.

Therapy this year

$2,318of $2,410
KX added to this visit97110 · KX

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