Chiropractic Coding & Compliance Alert
Reader Questions:
When Do You Not Submit a Claim to Medicare?
Published on Fri Apr 10, 2015 
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Question: Do I have to submit a claim to Medicare if the beneficiary agrees to pay for the service?
Minnesota Subscriber
Answer: Remember that no matter what the beneficiary is agreeing to, you have fee restrictions in place and mandatory claim submission still applies. The only exception to this would be if the beneficiary specifically requests that you NOT bill Medicare. Even in that case, though you would NOT submit a claim, the fee restrictions would still apply.
Make sure you document that the patient requested not to bill Medicare and that you do not bill under a Medicare claim in that case.
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