Wiki Collecting $ From Medicare Patients

[butterfly13]

Does anyone know... Can you only bill a Medicare patient the Medicare allowed amount of a Medicare covered benefit, regardless if Medicare is primary or secondary? I have a patient that has Blue Shield primary, whom we are non- contracted with, and Medicare secondary and I am trying to determine what is the corect amount to collect from the patient...

 

[nelamaria]

since you are not contracted with BCBS, charge will be applied to pt deductible and you can bill medicare as the primary, they will paid the 80% and you collect from the pt the 20%.

 

[apeck]

you could always have them sign an ABN to ensure you get payment for what is not covered under Medicare.

 

[Lisa Bledsoe]

It is my understanding that if a patient has Medicare as a secondary you can only bill the limiting Medicare rate. Someone please correct me if I'm wrong.

 

[RebeccaWoodward*]

My understand as well...

http://www.cms.hhs.gov/manuals/downloads/msp105c03.pdf

10.1

http://www.lamedicare.com/provider/msp/MSPResourceGuide.pdf