Hello All,
I have an updated contract that is only allowing 75% of CMS Clinical Lab fee schedule, which is new this year as it has always been 110%. When I questioned it with our provider rep, I was informed that it was not a typo but what the new policy is.
This does not seem Right, as I was informed on many occasions, that you can not have a private contract that allows for less then Medicare and still bill Medicare at their established rate.
I have been trying to find info on accepting/or not accepting a lower contracted rate then Medicare Fee Schedule but have been unable to find what I need, and was hoping for some of you great members to point me in the correct direction to find the info to give the Insurance company when I contact them again regarding this.
I should say my physicians are currently considering dropping our Medicare contract, next year because reimbursement is so low, and if other insurances start following suit I am not sure what I will do.
I have an updated contract that is only allowing 75% of CMS Clinical Lab fee schedule, which is new this year as it has always been 110%. When I questioned it with our provider rep, I was informed that it was not a typo but what the new policy is.
This does not seem Right, as I was informed on many occasions, that you can not have a private contract that allows for less then Medicare and still bill Medicare at their established rate.
I have been trying to find info on accepting/or not accepting a lower contracted rate then Medicare Fee Schedule but have been unable to find what I need, and was hoping for some of you great members to point me in the correct direction to find the info to give the Insurance company when I contact them again regarding this.
I should say my physicians are currently considering dropping our Medicare contract, next year because reimbursement is so low, and if other insurances start following suit I am not sure what I will do.