
Currently, Medicare Advantage plans are not required to reimburse teaching hospitals for Indirect Medical Education (IME) / Graduate Medical Education (GME) payments.
Consequently, teaching hospitals must create a “shadow claim” in order to receive IME/GME payments from Medicare when the patient is enrolled in a Medicare Advantage plan. This requires that hospital registration staff capture the patient’s Medicare number.
However, should hospital registration staff not capture the patient’s Medicare number, along with his/her Medicare Advantage number, the hospital will not be able to bill for the IME/GME payment and will miss significant reimbursement.
MCare is able to conduct retrospective review and retroactive reimbursement to the beginning of the timely filing period for IME/GME reimbursement.