Re: Are we required to take Medicare patients?

[Guest guest]

,

If that was the ODOC medicare seminar, I attended it also and I thought (please correct me if I'm wrong), that with medicare age MVA patients, we only needed to have them sign the medicare assignment of benefits paper and let them know that medicare will not cover the therapies, or anything other than the adjustment. I explain to them that if the MVA ins tanks for some reason, they have to understand that we will bill them for everything but the adjustment. We only bill medicare if the MVA ins falls thru. We also explain that if greater than one yr passes before we know that the MVA ins covers, they are also be responsible to pay the bills. That being said, we've offered a senior discount once when this happened. SO far, it's never been a problem. The only time it was is when a very unscrupulous claims adjustor convinced the senior to sign a check. The senior was misled to believe that the check was their settlement and the ins would pay for services at my office. Disgusting how some claims people treat the aged population.

Minga Guerrero DC

In a message dated 1/11/2008 10:32:42 A.M. Pacific Standard Time, backtohealth@... writes:

At a medicare seminar recently, I heard the same thing. Once you have been in the Medicare system you can never see medicare patients as cash patients. In fact, even if they are involved in an MVA, you are required to bill Medicare as well, even though they are not expected to pay. I am far from an expert but, I would say with Medicare right now, err on the side of caution. We should all be very careful holding onto a ship sinking faster than the Titanic. They are going to take down a lot of doctors with them.

Start the year off right. Easy ways to stay in shape in the new year.

[Guest guest]

At a medicare seminar recently, I heard the same thing. Once you have been in

the Medicare system you can never see medicare patients as cash patients. In

fact, even if they are involved in an MVA, you are required to bill Medicare as

well, even though they are not expected to pay.

I am far from an expert but, I would say with Medicare right now, err on the

side of caution. We should all be very careful holding onto a ship sinking

faster than the Titanic. They are going to take down a lot of doctors with them.

---- hrtchi <billhartje@...> wrote:

> I've read that some offices in the US don't take Medicare patients at

> all. Are we, as PAR with Medicare, obligated to take all Medicare

> patients or can we tell them we don't accept Medicare?

>

> If we can tell them we don't accept, it is my understanding that we

> can't take them on as a cash patient. Am I correct?

>

> Thanks,

>

> Jo Yip

>

> Office Assistant to Dr. Hartje

>

[Guest guest]

Jo,

Bottom line with Medicare...if you treat a medicare recipient and their part B benefits are primary, you must bill Medicare (par and non-par alke). If another insurer is primary (eg. PIP, Work Comp), then of course Medicare becomes secondary and needs not be billed unless there is reasonable doubt as to if the primary will pay. If the primary denies then Medicare will require proof of denial. Even then, Medicare will only reimburse for manipulation and only according to the Medicare fee schedule. The only exception is that rare Medicare recipient who, "of their own free will" (and you better have it in writing), forbids you to bill Medicare. But even that case may come back to haunt you if that recipient later changes his/her mind. Then you are required to back bill Medicare. Be careful with any "senior discounts" as Medicare may consider any discount an "inducement" which Medicare prohibits. J. Holzapfel, DCAlbany, Oregon-- "hrtchi" <billhartje@...> wrote:

I've read that some offices in the US don't take Medicare patients atall. Are we, as PAR with Medicare, obligated to take all Medicarepatients or can we tell them we don't accept Medicare?If we can tell them we don't accept, it is my understanding that wecan't take them on as a cash patient. Am I correct?Thanks,Jo YipOffice Assistant to Dr. Hartje

_____________________________________________________________Dreaming of getting away? Click here for an island experience in Hawaii.

[Guest guest]

I gotta say,

I had recently re-instated medicare in my office and it has been a nightmare. I did it as a favor to a patient. I'm still trying to figure out how to fill the HCFA out to their liking and have yet to be paid on 4 visits the lady has accumulated as well as 5 new medicare patients. A colossal waste of time. Now i remember why i stopped accepting it in the first place. I no longer feel sympathy for these folks. They most times require more time during history and treatment than any other patients. They can fork over the cash rate in my office for now on, which leads me to my question.

HOW DO I GET OUT NOW????????????????????

I don't want to accept anymore and want to drop out as soon as i am re-imbursed for what i've done.

ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211

Re: Are we required to take Medicare patients?

Jo,

Bottom line with Medicare...if you treat a medicare recipient and their part B benefits are primary, you must bill Medicare (par and non-par alke). If another insurer is primary (eg. PIP, Work Comp), then of course Medicare becomes secondary and needs not be billed unless there is reasonable doubt as to if the primary will pay. If the primary denies then Medicare will require proof of denial. Even then, Medicare will only reimburse for manipulation and only according to the Medicare fee schedule. The only exception is that rare Medicare recipient who, "of their own free will" (and you better have it in writing), forbids you to bill Medicare. But even that case may come back to haunt you if that recipient later changes his/her mind. Then you are required to back bill Medicare. Be careful with any "senior discounts" as Medicare may consider any discount an "inducement" which Medicare prohibits. J. Holzapfel, DCAlbany, Oregon-- "hrtchi" <billhartjeverizon (DOT) net> wrote:

I've read that some offices in the US don't take Medicare patients atall. Are we, as PAR with Medicare, obligated to take all Medicarepatients or can we tell them we don't accept Medicare?If we can tell them we don't accept, it is my understanding that wecan't take them on as a cash patient. Am I correct?Thanks,Jo YipOffice Assistant to Dr. Hartje_____________________________________________________________Dreaming of getting away? Click here for an island experience in Hawaii.

[Guest guest]

Joe....gonna play Devil's Advocate with you for a minute.

You have established a pathway for people of another generation to get care they have needed for their entire life. It has a convuluted pathway to payment and it requires that you stand down - to a modicum - from your usual pace. You are serving people who have limited time left on the planet...wouldn't you agree they deserve as much physiological peace as they can find? Aren't you the major player in that search?

If you will avoid expecting payment at your normal pace, you will get paid. Yes, it takes a while. Yes, it is annoying. Yes, it takes the gal a bit more time to credit it all correctly and yes, your spread sheet will have a 'write-off' column. But, some of the most deserving people in our community are recieving care. Some of the most uncomfortable people in our community are actually getting some sleep. Others whom you serve are able to now bend down and pick up their grandchildren ... maybe even go for a walk with them. Isn't that worth a bit of your time?

It is for me but then I am amongst that generation .... and without chiropractic, I can hurt like hell. With it, I have a smile on my face, I jump and hop around my office like there is no tomorrow, I sleep like a champ and I have NO pain. For that privilege, it is okay with me to wait a bit of time for payment. Serving my brethern - and letting them finally understand what chiropractic CAN do - seems more important.

My 2 cents.

Sunny

Sunny Kierstyn, RN DC Fibromyalgia Care Center of Oregon 2677 Willakenzie Road, 7C

Eugene, Oregon, 97401

541- 344- 0509; Fx; 541- 344- 0955

billhartje@...; ; kjholzdc@...From: deadmed@...Date: Mon, 14 Jan 2008 11:26:43 -0800Subject: Re: Are we required to take Medicare patients?

I gotta say,

I had recently re-instated medicare in my office and it has been a nightmare. I did it as a favor to a patient. I'm still trying to figure out how to fill the HCFA out to their liking and have yet to be paid on 4 visits the lady has accumulated as well as 5 new medicare patients. A colossal waste of time. Now i remember why i stopped accepting it in the first place. I no longer feel sympathy for these folks. They most times require more time during history and treatment than any other patients. They can fork over the cash rate in my office for now on, which leads me to my question.

HOW DO I GET OUT NOW????????????????????

I don't want to accept anymore and want to drop out as soon as i am re-imbursed for what i've done.

ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211

Re: Are we required to take Medicare patients?

Jo,

Bottom line with Medicare...if you treat a medicare recipient and their part B benefits are primary, you must bill Medicare (par and non-par alke). If another insurer is primary (eg. PIP, Work Comp), then of course Medicare becomes secondary and needs not be billed unless there is reasonable doubt as to if the primary will pay. If the primary denies then Medicare will require proof of denial. Even then, Medicare will only reimburse for manipulation and only according to the Medicare fee schedule. The only exception is that rare Medicare recipient who, "of their own free will" (and you better have it in writing), forbids you to bill Medicare. But even that case may come back to haunt you if that recipient later changes his/her mind. Then you are required to back bill Medicare. Be careful with any "senior discounts" as Medicare may consider any discount an "inducement" which Medicare prohibits. J. Holzapfel, DCAlbany, Oregon-- "hrtchi" <billhartjeverizon (DOT) net> wrote:

I've read that some offices in the US don't take Medicare patients atall. Are we, as PAR with Medicare, obligated to take all Medicarepatients or can we tell them we don't accept Medicare?If we can tell them we don't accept, it is my understanding that wecan't take them on as a cash patient. Am I correct?Thanks,Jo YipOffice Assistant to Dr. Hartje_____________________________________________________________Dreaming of getting away? Click here for an island experience in Hawaii.

Get the power of Windows + Web with the new Windows Live. Get it now!

[Guest guest]

I'm sorry for not responding sooner...but I'm afraid Chiropractors, unlike MDs and DOs are not allowed to "opt-out" of Medicare. As I wrote to Jo, if you treat a Medicare patient you are obligated to bill Noridian, regardless if you are par or non-par. The only exception is if the patient, of their own free will, will not give you their permission to bill Noridian. BUT, you better document that fact VERY CAREFULLY and remain prepared to send a bill to Noridian for ALL services provided but not billed should the patient or any of their legal representatives change his/her mind at ANY time. I would be happy to work with you to iron out any problems you may be having with completing the CMS-1500 assuming you are billing by paper. Yes, there are big problems with the system, particularly with the advent of the NPI. But, the process is quite simple compared to what our medical counterparts are required to do. Last I heard Noridian is working on a billing education webinar. As soon as that is available I'll let everyone know. Contact me at my office, 541-928-4060, or by this forum. J. Holzapfel, DCAlbany, Oregon-- "deadmed" <deadmed@...> wrote:

I gotta say,

I had recently re-instated medicare in my office and it has been a nightmare. I did it as a favor to a patient. I'm still trying to figure out how to fill the HCFA out to their liking and have yet to be paid on 4 visits the lady has accumulated as well as 5 new medicare patients. A colossal waste of time. Now i remember why i stopped accepting it in the first place. I no longer feel sympathy for these folks. They most times require more time during history and treatment than any other patients. They can fork over the cash rate in my office for now on, which leads me to my question.

HOW DO I GET OUT NOW????????????????????

I don't want to accept anymore and want to drop out as soon as i am re-imbursed for what i've done.

ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211

Re: Are we required to take Medicare patients?

Jo,

Bottom line with Medicare...if you treat a medicare recipient and their part B benefits are primary, you must bill Medicare (par and non-par alke). If another insurer is primary (eg. PIP, Work Comp), then of course Medicare becomes secondary and needs not be billed unless there is reasonable doubt as to if the primary will pay. If the primary denies then Medicare will require proof of denial. Even then, Medicare will only reimburse for manipulation and only according to the Medicare fee schedule. The only exception is that rare Medicare recipient who, "of their own free will" (and you better have it in writing), forbids you to bill Medicare. But even that case may come back to haunt you if that recipient later changes his/her mind. Then you are required to back bill Medicare. Be careful with any "senior discounts" as Medicare may consider any discount an "inducement" which Medicare prohibits. J. Holzapfel, DCAlbany, Oregon-- "hrtchi" <billhartjeverizon (DOT) net> wrote:

I've read that some offices in the US don't take Medicare patients atall. Are we, as PAR with Medicare, obligated to take all Medicarepatients or can we tell them we don't accept Medicare?If we can tell them we don't accept, it is my understanding that wecan't take them on as a cash patient. Am I correct?Thanks,Jo YipOffice Assistant to Dr. Hartje_____________________________________________________________Dreaming of getting away? Click here for an island experience in Hawaii.

_____________________________________________________________Ultimate Travel Deals - Click Now!

[Guest guest]

Doc, My understanding is you can see them, have them pay you no more than the limiting charge but you are required to bill medicare on their behalf and you better have the ABN filled out for each visit or medicare can require you to refund for visits that medicare determines are not medically necessary. Please correct me if I'm wrong. Another consideration that I'm running into is that some of my patient population that I have seen for many years are aging and billing medicare is becoming a necessity for my office if I'm going to continue to see these people.

Rick

M. Balsiger, Jr., D.C.Balsiger Chiropractic Center1019 N.E. 122nd AvenuePortland, Oregon 97230503 257-8606Start the year off right. Easy ways to stay in shape in the new year.

[Guest guest]

Regarding PIP or Work Comp:

Are we required to bill medicare rates for a Medicare patient who is

under the PIP or Work comp insurance as primary? My office manager and

I went to a Medicare seminar about four years back and got the

impression that even if the accident insurance is primary, we could

only charge what medicare would pay to the accident insurance carrier,

then bill Medicare as secondary ifthe non-medicare did not pay.

I hope we are just confused.

Although, this is Medicare.

Annette

On Monday, January 14, 2008, at 08:37 PM, J. Holzapfel, DC wrote:

> I'm sorry for not responding sooner...but I'm afraid Chiropractors,

> unlike MDs and DOs are not allowed to " opt-out " of Medicare.  As I

> wrote to Jo, if you treat a Medicare patient you are obligated to

> bill Noridian, regardless if you are par or non-par.  The only

> exception is if the patient, of their own free will, will not give you

> their permission to bill Noridian.  BUT, you better document that fact

> VERY CAREFULLY and remain prepared to send a bill to Noridian for ALL

> services provided but not billed should the patient or any of their

> legal representatives change his/her mind at ANY time.  I would be

> happy to work with you to iron out any problems you may be having with

> completing the CMS-1500 assuming you are billing by paper.  Yes, there

> are big problems with the system, particularly with the advent of the

> NPI.  But, the process is quite simple compared to what our medical

> counterparts are required to do.  Last I heard Noridian is working on

> a billing education webinar.  As soon as that is available I'll let

> everyone know.  Contact me at my office, 541-928-4060, or by this

> forum. 

>

> J. Holzapfel, DC

> Albany, Oregon

>

> -- " deadmed " <deadmed@...> wrote:

> I gotta say,

> I had recently re-instated medicare in my office and it has been a

> nightmare. I did it as a favor to a patient. I'm still trying to

> figure out how to fill the HCFA out to their liking and have yet to be

> paid on 4 visits the lady has accumulated as well as 5 new medicare

> patients. A colossal waste of time.  Now i remember why i stopped

> accepting it in the first place. I no longer feel sympathy for these

> folks. They most times require more time during history and treatment

> than any other patients.  They can fork over the cash rate in my

> office for now on, which leads me to my question.

>  

> HOW DO I GET OUT NOW????????????????????

>  

> I don't want to accept anymore and want to drop out as soon as i am

> re-imbursed for what i've done.

>  

>  

> ph Medlin, DC

> Spine Tree Chiropractic

> 1627 NE Alberta St.

> Portland, OR 97211

>

> Re: Are we required to take Medicare

> patients?

>

>

>

> Jo,

>

> Bottom line with Medicare...if you treat a medicare recipient and

> their part B benefits are primary, you must bill Medicare (par and

> non-par alke).  If another insurer is primary (eg. PIP, Work Comp),

> then of course Medicare becomes secondary and needs not be billed

> unless there is reasonable doubt as to if the primary will pay.  If

> the primary denies then Medicare will require proof of denial.  Even

> then, Medicare will only reimburse for manipulation and only according

> to the Medicare fee schedule.  The only exception is that rare

> Medicare recipient who, " of their own free will " (and you better have

> it in writing), forbids you to bill Medicare.  But even that case may

> come back to haunt you if that recipient later changes his/her mind. 

> Then you are required to back bill Medicare.  Be careful with any

> " senior discounts " as Medicare may consider any discount an

> " inducement " which Medicare prohibits.   

>

>

> J. Holzapfel, DC

> Albany, Oregon

>

> -- " hrtchi " <billhartje@...> wrote:

>

> I've read that some offices in the US don't take Medicare patients at

> all. Are we, as PAR with Medicare, obligated to take all Medicare

> patients or can we tell them we don't accept Medicare?

>

> If we can tell them we don't accept, it is my understanding that we

> can't take them on as a cash patient. Am I correct?

>

> Thanks,

>

> Jo Yip

>

> Office Assistant to Dr. Hartje

>

>

>

> _____________________________________________________________

> Dreaming of getting away? Click here for an island experience in

> Hawaii.

>

>

>

>

>

> _____________________________________________________________

> Ultimate Travel Deals - Click Now!

>

[Guest guest]

I absolutely see the humanity side of it. For example I would be less perturbed if i received 15$/visit and it took 2 months to be paid,and that was it. The problem for me is the re-billing and the time. The tightrope we are expected to walk in filling out the HCFA etc. Spending more time, getting paid less and waiting for payment indefinitely is a 3fold negative. For some DC's medicare is ingrained in their office. They have a system down and it works. They may not even think about it much. But,someone such as me that has a very low percentage of these patients runs into a time consuming debacle and the metaphoric wrench is thrown into the works when one shows up. I could be helping 2-3 other people with the time wasted on this beurocreacy. How is this helping humanity?

Can i see medicare folks, charge them and have them get re-imbursed by medicare?

ph Medlin, DCSpine Tree Chiropractic1627 NE Alberta St.Portland, OR 97211

Re: Are we required to take Medicare patients?

Jo,Bottom line with Medicare...if you treat a medicare recipient and their part B benefits are primary, you must bill Medicare (par and non-par alke). If another insurer is primary (eg. PIP, Work Comp), then of course Medicare becomes secondary and needs not be billed unless there is reasonable doubt as to if the primary will pay. If the primary denies then Medicare will require proof of denial. Even then, Medicare will only reimburse for manipulation and only according to the Medicare fee schedule. The only exception is that rare Medicare recipient who, "of their own free will" (and you better have it in writing), forbids you to bill Medicare. But even that case may come back to haunt you if that recipient later changes his/her mind. Then you are required to back bill Medicare. Be careful with any "senior discounts" as Medicare may consider any discount an "inducement" which Medicare prohibits. J. Holzapfel, DCAlbany, Oregon-- "hrtchi" <billhartjeverizon (DOT) net> wrote:

I've read that some offices in the US don't take Medicare patients atall. Are we, as PAR with Medicare, obligated to take all Medicarepatients or can we tell them we don't accept Medicare?If we can tell them we don't accept, it is my understanding that wecan't take them on as a cash patient. Am I correct?Thanks,Jo YipOffice Assistant to Dr. Hartje_____________________________________________________________Dreaming of getting away? Click here for an island experience in Hawaii.

Get the power of Windows + Web with the new Windows Live. Get it now!

[Guest guest]

All:

We no longer bill medicare, or deal with them in any way but still

have a fair number of medicare benficiaries as patients...they pay

cash. LEGALLY. The truth is, only a PATIENT can " opt " out of medicare.

Medicare is an " entitlement " (you can use it if you want) not a

" mandate " (you must use it or else).

I will not post how to do this for the 15th time...but anyone who is

interested should get a ID and log into the OeognDCs homepage

so that you can access the bounty of archived posts that exist on the

subject.

I used to feel diffrently about medicare 6-7 years ago...I felt that

it was workable and 'doable'...but then about 2-3 years ago I actually

sat down and really looked at our office numbers...the REAL

" nitty-gritty " .

Our hourly overhead was about 100/doctor-hour (i know some of you have

much less than that, good for you) according to the last ACA random

sample survey that I have seen (it was from about 6-7 years ago) the

avg. DC overhead per doctor-hour was about 76/hour for a single doctor

office...and overhead has not gone down as we all know....so the

nationwide avg is prolly pushing up toward 100/doctor-hour. (clinic hours)

I was very good at billing medicare...our office was expert at it in

fact. I would say we were better at it than 95+% of the chiros in this

state. But even with our expertise I found that my office overhead for

dealing with medicare beneficiaries went up to about about

$110/doctor-hour due to extra doctor time and extra staff time needed.

We had numerous scenarios wherein a staff member was paid 15-17/hour

while spending a full hour chasing down 26 dollars from medicare!!!!!

After very careful analysis I found that my average collection for

medicare patients was about 125/doctor-hour...hey a profit of 15/hour!

My high school niece makes 17/hour off the books baby-sitting back in

NY.I recently paid a guy 200/hour for a coupla hours to slap morter on

our chimney!!! C'mon kids. Now granted this is only MY office, other

docs might run their office different but to the best of my knowledge

we are a pretty mean and lean operation. So, I was profiting 15/hour

per patient....and, I saw that the percentage of medicare bennies was

slowly and steadily going upward.....you see where things are going?

I envisioned an office that was 25% medicare patients with me making

15/hour on these patients!!!!!

So we got out!!!!

NO REGRETS VERY Good business decision..In fact, to stay in (for me)

would have been self-destructive, not only to me, but to my other

patients so it was the only rational decision that was possible. I was

NOT showing COMPASSION by staying in. I was NOT being HUMANE by

participating in this system.. I was just slowly DESTROYING my practice.

So nowadays we see a smaller number of medicare-eligibles, bout half

as many as before (the folks have chosen to opt out of their own free

will...these are very pleasant and responsible seniors BTW, most of

whom work out and have a positive mindset and are NOT walking chemical

expriments etc.) but we operate at about 80/hour profit margin with

them...very SUSTAINABLE.

:-)

Finally:

Every office is unique..some of you might be making 30-60/doctor-hour

profit or more off of these patients...others might be more like

us...but I urge you to check out the bottom line in your individual

case..the 'bottom line' for us was this: Medicare was UNSUSTAINABLE

and therefore DESTRUCTIVE and therefore UNACCEPTABLE. So we are done

with that bone-headed, screwed up, deMENTED system. I have never

looked back. Now if they raise the reimbursement rate by about 10

dollars per adjustment, we will re-visit.

P.S. The ICA is the only chiro organization with a sane attitude

toward medicare. They have consistently pushed and asked for a change

in federal law that would simply allow chiros the same option to opt

out that MDs already have. But the ACA has fought that approach and

pushed for MORE inclusion into a system that is very difficult to make

a fair profit in.

Cheers.

>

> I've read that some offices in the US don't take Medicare patients

atall. Are we, as PAR with Medicare, obligated to take all

Medicarepatients or can we tell them we don't accept Medicare?If we

can tell them we don't accept, it is my understanding that wecan't

take them on as a cash patient. Am I correct?Thanks,Jo YipOffice

Assistant to Dr.

Hartje_____________________________________________________________Dreaming

of getting away? Click here for an island experience in Hawaii.

>

>

>

>

>

>

>

>

> _________________________________________________________________

> Get the power of Windows + Web with the new Windows Live.

> http://www.windowslive.com?ocid=TXT_TAGHM_Wave2_powerofwindows_012008

>

[Guest guest]

Joe,

Yes, that's called being non-assigned. I take medicare patients, treat them, they pay me for service rendered at the Medicare rate and I send in the HCFA and Medicare sends them $18 or $19 or $30 in three months or whenever they get around to it. Takes the paying time burden away and frees up the time to treat more of these folks, who really do need our care. One thing -- you must have facility with the HCFA, which you can get by getting a copy of the Medicare manual or taking the online courses Noridian has. If the enrollment time is still open you can change your status. If it's closed you're stuck until next November.

Christian Mathisen, D.C.

3654 S Pacific Hwy

Medford, OR

cmathdc@...

Re: Are we required to take Medicare patients?

Jo,Bottom line with Medicare...if you treat a medicare recipient and their part B benefits are primary, you must bill Medicare (par and non-par alke). If another insurer is primary (eg. PIP, Work Comp), then of course Medicare becomes secondary and needs not be billed unless there is reasonable doubt as to if the primary will pay. If the primary denies then Medicare will require proof of denial. Even then, Medicare will only reimburse for manipulation and only according to the Medicare fee schedule. The only exception is that rare Medicare recipient who, "of their own free will" (and you better have it in writing), forbids you to bill Medicare. But even that case may come back to haunt you if that recipient later changes his/her mind. Then you are required to back bill Medicare. Be careful with any "senior discounts" as Medicare may consider any discount an "inducement" which Medicare prohibits. J. Holzapfel, DCAlbany, Oregon-- "hrtchi" <billhartjeverizon (DOT) net> wrote:

I've read that some offices in the US don't take Medicare patients atall. Are we, as PAR with Medicare, obligated to take all Medicarepatients or can we tell them we don't accept Medicare?If we can tell them we don't accept, it is my understanding that wecan't take them on as a cash patient. Am I correct?Thanks,Jo YipOffice Assistant to Dr. Hartje_____________________________________________________________Dreaming of getting away? Click here for an island experience in Hawaii.

Get the power of Windows + Web with the new Windows Live. Get it now!

[Guest guest]

Ad me to the list of folks who have had it with medicare madness. I cannot deal with the HCFA form games anymore. I am currently treatinig patients without performing any adjustments, thus eliminating need to bill Medicare gang. I use active release, and message and other modalities. I am exploring a way to add adjusting while legally avoiding billing the monster medicare folks.

Schneider

PDX

On Mon Jan 14 11:26 , "deadmed" sent:

I gotta say,

I had recently re-instated medicare in my office and it has been a nightmare. I did it as a favor to a patient. I'm still trying to figure out how to fill the HCFA out to their liking and have yet to be paid on 4 visits the lady has accumulated as well as 5 new medicare patients. A colossal waste of time. Now i remember why i stopped accepting it in the first place. I no longer feel sympathy for these folks. They most times require more time during history and treatment than any other patients. They can fork over the cash rate in my office for now on, which leads me to my question.

HOW DO I GET OUT NOW????????????????????

I don't want to accept anymore and want to drop out as soon as i am re-imbursed for what i've done.

ph Medlin, DC

Spine Tree Chiropractic

1627 NE Alberta St.

Portland, OR 97211

Re: Are we required to take Medicare patients?

Jo,

Bottom line with Medicare...if you treat a medicare recipient and their part B benefits are primary, you must bill Medicare (par and non-par alke). If another insurer is primary (eg. PIP, Work Comp), then of course Medicare becomes secondary and needs not be billed unless there is reasonable doubt as to if the primary will pay. If the primary denies then Medicare will require proof of denial. Even then, Medicare will only reimburse for manipulation and only according to the Medicare fee schedule. The only exception is that rare Medicare recipient who, "of their own free will" (and you better have it in writing), forbids you to bill Medicare. But even that case may come back to haunt you if that recipient later changes his/her mind. Then you are required to back bill Medicare. Be careful with any "senior discounts" as Medicare may consider any discount an "inducement" which Medicare prohibits.

J. Holzapfel, DC

Albany, Oregon

-- "hrtchi" net> wrote:

I've read that some offices in the US don't take Medicare patients at

all. Are we, as PAR with Medicare, obligated to take all Medicare

patients or can we tell them we don't accept Medicare?

If we can tell them we don't accept, it is my understanding that we

can't take them on as a cash patient. Am I correct?

Thanks,

Jo Yip

Office Assistant to Dr. Hartje

_____________________________________________________________

Dreaming of getting away? Click here for an island experience in Hawaii.