Results 1 to 5 of 5

Question????

  1. #1
    Question Question????
    Medical Coding Books
    I have a question and need help.

    this is the example:

    Patient provider recently opted out of medicare, and the patient needs to have a double masectomy done.

    the question is can a non par provider bill for the surgery? or can the patient submitted the claim?

    Will the provider receive payment or the patient?

    does the provider have to follow medicare guidelines or are they exempt from the guidelines?

    can they balance bill the patient for the whole amount not paid???

    I know it is many questions, but you input is important....
    Ivonne Atanacio CPC,CPB,CPMA,CPC-I

  2. #2
    Default
    The patient cannot submit the bill, the provider must always submit for Medicare. I think he can still do the procedures, but I think the patient may get the payment. Not sure on that part.

  3. #3
    Default
    There would be no billing of medicare at all under this circumstance. It would be payment arrangements between the patient and the provider. I just doubled checked with my medicare guru on this.

  4. #4
    Default
    It would be considered a self pay surgery

  5. #5
    Default
    http://www.cms.hhs.gov/manuals/Downloads/bp102c15.pdf

    This should have the info you need.

    Laura, CPC, CPMA, CEMC

Similar Threads

  1. ROS Question and Exam Bullet Question
    By Stefanie in forum Auditing General Discussion
    Replies: 1
    Last Post: 05-21-2010, 05:04 PM
  2. Replies: 5
    Last Post: 10-13-2008, 08:55 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.