I'm new to billing and have a few questions about Medicare Capitation. In the last 6 months I've had Medicare deny payment on 4 visits due to a capitation agreement. The Dr. is upset that we've basically let 4 patients be seen for free and he wants me to find out which patients are affected by the capitation agreement.
As I understand it Medicare will only pay a certain amount to a practice each month. If we bill more than that amount they will deny the claims because of capitation. Do I have that right?
How can I find out how much our limit is?
How can I find out which Medicare plans are affected? Is it exclusive to Part A or B? Or does it include all Medicare plans?
Any and all information would be helpful. Thank you in advance.
As I understand it Medicare will only pay a certain amount to a practice each month. If we bill more than that amount they will deny the claims because of capitation. Do I have that right?
How can I find out how much our limit is?
How can I find out which Medicare plans are affected? Is it exclusive to Part A or B? Or does it include all Medicare plans?
Any and all information would be helpful. Thank you in advance.
