Wiki Collecting Medicare Deductible

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DianaK8@aol.com

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I had a recent experience where a surgery center insisted I pay my Medicare deductible to them when I presented for my surgery. I explained I had met part of the Medicare deductible for 2019 already from other medical bills. The reply was "we collect the Medicare deductible from all of our patinets". I had received a phone call from them prior to surgery which stated I had a Medicare deductible but did not say I had to pay it the day of the surgery. I
had always been told that physcian offices were not allowed to collect the Medicare deductible up front, that it was against Medicare regulations. I cannot find documentation of that regulation. Is it an actual regulation or just a suggestion?
 
Alternatively, call Medicare and ask them directly. Make sure you have all pertinent information about the surgery center and they can look the center up if needs be.
I had an eye doctor practice do the same for one of my family members, and I told them I would pay the copay and they could bill me the rest if there still was anything else I had to pay afterwards. They obliged and I received an appropriate bill and paid it in full after the visit.

Doesn't seem like an illegal practice, but less-than stellar customer service or business practice. I get that they want to make sure they get some of the money up front, but it can easily turn into an annoying hassle for the patient down the road.
 
Try looking at the reference in this FAQ I found on our MAC website. I had always been told we couldn't collect until Medicare processed claims.

When can the provider request deductible or co-insurance at the time of service?
Answer:
According to the CMS Internet-Only Manual (IOM) Publication 100-4, Chapter 2, Section 10.4, the provider may collect deductible or coinsurance amounts only where it appears that the patient will owe deductible or coinsurance and where it is routine and customary policy to request similar prepayment from non-Medicare patients with similar benefits that leave patients responsible for a part of the cost of their hospital services. In admitting or registering patients, the provider must ascertain whether beneficiaries have medical insurance coverage. When beneficiary has medical insurance coverage, the provider asks the beneficiary if they have a Medicare Summary Notice (MSN) showing his/her deductible status. If a beneficiary shows that the Part B deductible is met, the provider will not request or require prepayment of the deductible.
Reviewed on Jan 24, 2018
Originally Published on Jan 30, 2017
 
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