The purpose of this article is to discuss what MACs are and how Artacent wound, a Tides Medical amniotic tissue product, is reimbursed for Medicare Part B patients in all 7 MACs across all 50 states. Before we get started, we will review a few terms that will be utilized throughout the post.
– MAC stands for Medicare Administrative Contractor. MAC is a private health care insurer that is given a geographic jurisdiction to process Medicare Part A and Part B (A/B) medical claims or DME (Durable Medical Equipment) claims for Medicare Fee-For-Service (FFS) beneficiaries.
-Medicare Part A – Medicare is broken down into different parts. This article will discuss Part A and B with a focus on Part B. Part A is hospital insurance. Part A Medicare covers inpatient care in hospitals, skilled nursing facilities, hospice and in home health care.
-Medicare Part B – Part B of Medicare is Medical Insurance. It helps to cover services from doctors and other health care providers, outpatient procedures and care, certain in-home health care, DME (discussed below) and certain preventive services such as screenings and wellness checks with health care providers.
-DME stands for Durable Medical Equipment. DME is equipment that is primarily used to serve a medical purpose and is meant to withstand repeated use. Some examples include wheelchairs, walkers, hospital beds, etc.
Brief Overview of MACs & Why They’re Important
MACs serve as the operational contact between Medicare’s FFS program and healthcare providers enrolled within the program. They operate across different regions and states and are responsible for administering claims for Medicare Part A and Part B. MACs are, in short, the middleman between health care providers and Centers for Medicare & Medicaid Services. MACs are responsible for conducting audits and educating healthcare providers. They determine what services needed may be covered and essentially handle the entire payment side of the FFS program.
MACs play an important role in determining which services are considered reasonable and necessary, and ensuring that providers get paid appropriately.
Artacent Wound, Amniotic Tissue Product Reimbursement
Artacent Wound is a wound specific amniotic tissue product manufactured by Tides Medical. This dual layer amniotic tissue graft is designed for ease of use and is a versatile wound covering that can be used for pressure ulcers, diabetic foot ulcers, venous stasis ulcers, burns, Mohs surgery & more. Artacent Wound is flexible in design, easy to use, safe, efficient and reimbursable.
Artacent Wound is covered for reimbursement in all 7 MACs across all 50 states. This Tides amniotic tissue product falls under Medicare Part B. Tides Medical has expert support staff available to help healthcare providers navigate the complex reimbursement process. Our full range of reimbursement support services allows you to focus on what you do best. All you need to do is submit a patient intake form, and our full-time dedicated team of experts help with:
-Coverage & Coding Help
-Out of pocket costs
FRM Services include:
-Staff onboarding & training
-Payer policy review & education
-Reimbursement support for your geographic region
If you have any questions about Tides Medical amniotic tissue products or the reimbursement process, do not hesitate to contact us for more information. Our goal is to make these advanced products available to all patients through their health care providers. Our expert service strives to remove any barrier that may prevent patients from receiving the full range of treatment they deserve.