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Medicare deductibles

  1. Default Medicare deductibles
    Medical Coding Books
    I have always been told that it is illegal to collect an entire Medicare Deductible up front but have never actually seen it documented. Even when i call the IVR it says not to collect it. I am now being questioned about this and i have read some conflicting articles. Please help and if you could provide a link to documentation.

  2. #2
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    Check out this link, it may answer your question.
    http://www.physicianspractice.com/in...798/page/2.htm

  3. #3
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    North Carolina
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    Quote Originally Posted by Earnose View Post
    I have always been told that it is illegal to collect an entire Medicare Deductible up front but have never actually seen it documented. Even when i call the IVR it says not to collect it. I am now being questioned about this and i have read some conflicting articles. Please help and if you could provide a link to documentation.
    Personally, I haven't heard this nor read this anywhere. Though, I may be hesitant to collect the ded/co-insurance if the insured had a 2ndry plan. Some plans pick up the deductible. Cuts down on refunds.

    10.1.3 - Part B Deductible and Coinsurance
    (Rev. 1, 09-11-02)

    The provider may charge the beneficiary or other person on his or her behalf: the $100 deductible and 20 percent of the customary (insofar as reasonable) charges in excess of that deductible. (deductible amount hasn't been updated in this chapter)

    For hospital outpatient services, the allowable deductible charges depend on whether the hospital can determine the beneficiary's deductible status. If the hospital is unable to determine the deductible status, it may charge the beneficiary its full customary charges up to $100. If the beneficiary provides official information as to deductible status, the hospital may charge only the unmet portion of the deductible.

    https://www1.cms.gov/manuals/downloads/ge101c05.pdf
    Last edited by RebeccaWoodward*; 05-19-2010 at 07:46 AM.

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