Admin. Assistant in Medical Office

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I have a general question about billing and reimbursement:

* If a patient has medicare and a supplemental insurance, is it permitted to send the medicare patient a bill for the balance that the supplemental insurance did not pay?
We receive EOBs from Medicare that show us a field entitled: "PT Responsibility." I called CMS and they claim that we can bill the patient for this, but I want to ask you as well. Can we bill a patient on Medicare with supplemental insurance?

Follow up Question:

If a patient has Medicare only. No Medicaid. No supplemental insurance. Can we bill this Medicare patient for the balance of what Medicare didn't reimburse?


Sharon L. Ippolito
Physical Medicine & Pain Center, Ewing, NJ
Patient Responsibility

If the balance is shown as "patient responsibility" and the patient has no supplemental insurance, then you are required to balance bill the patient that amount.

If the patient has supplemental insurance, it will depend on what THAT secondary insurance EOB states with respect to any noncovered charge(s).

Hope that helps.

F Tessa Bartels, CPC, CEMC