Noridian Healthcare Solutions has a dedicated webpage that provides instructions how to view a beneficiary’s Medicare eligibility: Part A, Part B, Health Maintenance Organization (HMO) and Managed Care Organization (MCO), Medicare Secondary Payer (MSP), Home Health, Hospice, End Stage Renal Disease (ESRD), Preventive Services and Medicare Diabetes Prevention Program (MDPP). If Noridian is your Medicare Administrative Contractor, this is a valuable resource as Noridian also gives instructions regarding how to identify if a Medicare beneficiary is enrolled in the Qualified Medicare Beneficiary (QMB) program. To access the instructions, click HERE.

Lately, I have been receiving questions regarding Medicare beneficiaries who are dually eligible (have Medicare primary and Medicaid secondary) and are enrolled in the Qualified Medicare Beneficiary (QMB) program. Medicare beneficiaries enrolled in the QMB program are also enrolled in Medicaid and get help with their Medicare premiums and cost-sharing. What providers want to know is can they bill the Medicare beneficiary who is enrolled in the QMB program for the 20% co-insurance the Medicare program does not cover as well as any deductible the Medicare beneficiary has not met yet if the Medicaid program does not pay that portion?