November 27, 2017
Introducing – The New Qualified Medicare Beneficiary (QMB) myCGS Sub-Tab!
The Qualified Medicare Beneficiary (QMB) Program is a State Medicaid benefit that assists low-income Medicare beneficiaries with Medicare Part A and Part B premiums and cost-sharing, including deductibles, coinsurance and copays. Because of this, you may not bill beneficiaries enrolled in the QMB program for Medicare cost-sharing, as they have no legal obligation to pay.
To help you determine the QMB status of your patients, CMS recently updated the HIPAA Eligibility Transaction System (HETS) to allow you access to this information. CMS requires us to utilize HETS 270/271 transactions to provide eligibility information to you when inquiries are submitted through our secure online web portal, myCGS. As a result, myCGS has been enhanced to coincide with the HETS updates in order to allow you access to this important information.
The new QMB sub-tab is available to you under the 'Eligibility' tab. Please note that "$0" will display in the deductible, coinsurance, and copay sections for beneficiaries enrolled in the QMB program.
If you would like access to this information and other time-saving functions but have not registered for myCGS, please do so TODAY!