Don’t assume your doctor takes Medicare – ask and make sure! Otherwise you may get a surprise – a bill to pay and no reimbursement!
Recently, a WSJ article http://online.wsj.com/home-page * explained three options physicians have with Medicare claims.
“Fewer American doctors are treating patients enrolled in the Medicare health program for seniors, reflecting frustration with its payment rates and pushback against mounting rules, according to health experts.
The number of doctors who opted out of Medicare last year, while a small proportion of the nation’s health professionals, nearly tripled from three years earlier…… Other doctors are limiting the number of Medicare patients they treat even if they don’t formally opt out of the system.
Doctors have three options for dealing with Medicare.
– Those who participate bill Medicare directly and must agree to accept its reimbursement rates for all covered services.
– So-called nonparticipating doctors still file Medicare reimbursement claims but can charge as much as 10% over Medicare’s rates for some services, and they must bill patients for the difference.
– Those who opt out can charge patients whatever they want, but they must forgo filing Medicare claims for two years, and their Medicare-eligible patients must pay out of pocket to see them.”
*to read the full WSJ article “More Doctors Steer Clear of Medicare” by Melinda Beck, highlight and click on open hyperlink
http://online.wsj.com/news/articles/SB10001424127887323971204578626151017241898?mg=reno64-wsj&url=http%3A%2F%2Fonline.wsj.com%2Farticle%2FSB10001424127887323971204578626151017241898.html