Re: co-pays

[Guest guest]

I usually bill it once without collecting the copay, just to make sure that the patient really owes the copay.  Then, if i find they do have to pay the secondary copay, i put a note in demographics that says " Pt owes 2a copay for each visit.  Collect at time of service. " that way the person that works the front desk (when it is not me) will collect it.  E-MDs will show a credit balance on the account until the claim is processed and payments (including the 2a) are posted.  There are a couple of ways around that, which I can tell you about if you do not want it showing a credit balance (easiest is to edit the copay amount on the Medicare line in the invoice, but that is not really accurate).  If the patient does not have to pay the copay, then I also put a note " no copay due " . I do this for other patients, who, for example, have an HSA that covers their copay after the fact, or when patients have reached their max for the year.

Typically, if it is a Medicare Supplemental Plan (Part F), then they do owe the copay.  I find that if it is a retiree plan from an employer, often there is no copay.Hope this helps,

Pratt

 

Hello and good morning.

Today I am the one asking ( Ardiana is hesitant to do it since her last question, I think I have thicker skin).

I am finding that when we have medicare and a secondary insurance, we dont ask for a copay when medicare is the principal insurance.

Today I found out via gateway that we were supposed to ask for the copay of the secondary insurance.

How is this done? I am thinking about sending the patients a bill for the copay.

thanks, Adolfo

PS: Thanks to about the link that you sent me.

[Guest guest]

thanks, I will talk to Ardiana about. She is dealing with that part. adolfo To: " " < > Sent: Friday, March 16, 2012 11:39 AM Subject: Re: co-pays

I usually bill it once without collecting the copay, just to make sure that the patient really owes the copay. Then, if i find they do have to pay the secondary copay, i put a note in demographics that says "Pt owes 2a copay for each visit. Collect at time of service." that way the person that works the front desk (when it is not me) will collect it. E-MDs will show a credit balance on the account until the claim is processed and payments (including the 2a) are posted. There are a couple of ways around that, which I can tell you about if you do not want it showing a credit balance (easiest is to edit the copay amount on the Medicare line in the invoice, but that is not really accurate). If the patient does not have to pay the copay, then I also put a note "no copay due". I do this for other patients, who, for example, have an HSA that covers their copay after the fact, or when patients have reached

their max for the year.

Typically, if it is a Medicare Supplemental Plan (Part F), then they do owe the copay. I find that if it is a retiree plan from an employer, often there is no copay.Hope this helps,

Pratt

Hello and good morning.

Today I am the one asking ( Ardiana is hesitant to do it since her last question, I think I have thicker skin).

I am finding that when we have medicare and a secondary insurance, we dont ask for a copay when medicare is the principal insurance.

Today I found out via gateway that we were supposed to ask for the copay of the secondary insurance.

How is this done? I am thinking about sending the patients a bill for the copay.

thanks, Adolfo

PS: Thanks to about the link that you sent me.

[Guest guest]

Adolfo,Some secondary’s pay the entire 20% and some still make the patient responsible for a copay. I never collect ahead as I find having to write patients checks to be more difficult than collecting the copay if it’s due. Kathy Saradarian, MDBranchville, NJwww.qualityfamilypractice.comSolo 4/03, Practicing since 9/90Practice Partner 5/03Low staffing From: [mailto: ] On Behalf Of Adolfo TeranSent: Friday, March 16, 2012 11:21 AMTo: IMPSubject: co-pays Hello and good morning.Today I am the one asking ( Ardiana is hesitant to do it since her last question, I think I have thicker skin).I am finding that when we have medicare and a secondary insurance, we dont ask for a copay when medicare is the principal insurance.Today I found out via gateway that we were supposed to ask for the copay of the secondary insurance.How is this done? I am thinking about sending the patients a bill for the copay. thanks, AdolfoPS: Thanks to about the link that you sent me.

[Guest guest]

Adolfo and na

Hope you were not hesitant to ask because of my previous response to a billing

question. If so I was a bit testy that day, and unfortunately took it out the

question.

Steve

>

> Hello and good morning.

> Today I am the one asking ( Ardiana is hesitant to do it since her last

question, I think I have thicker skin).

> I am finding that when we have medicare and a secondary insurance, we dont ask

for a copay when medicare is the principal insurance.

> Today I found out via gateway that we were supposed to ask for the copay of

the secondary insurance.

> How is this done? I am thinking about sending the patients a bill for the

copay.

> thanks, Adolfo

> PS: Thanks to about the link that you sent me.

>

[Guest guest]

Dear Steve.

Dont worry about it, I ask for her. ( my wife is a shy girl)

Take care, Adolfo

To: Sent: Saturday, March 17, 2012 11:00 AMSubject: Re: co-pays

Adolfo and naHope you were not hesitant to ask because of my previous response to a billing question. If so I was a bit testy that day, and unfortunately took it out the question.Steve>> Hello and good morning.> Today I am the one asking ( Ardiana is hesitant to do it since her last question, I think I have thicker skin).> I am finding that when we have medicare and a secondary insurance, we dont ask for a copay when medicare is the principal insurance.> Today I found out via gateway that we were supposed to ask for the copay of the secondary insurance.> How is this done? I am thinking about sending the patients a bill for the copay. > thanks,

Adolfo> PS: Thanks to about the link that you sent me.>

[Guest guest]

Adolfo,You are correct. Medicare does not reimburse for co-pays for 2ndary insurance. Despite the patients assumption to the contrary, if their secondary insurance has a co-pay, collect it. Also don’t assume that if the patient has Medicare and another insurance that the other insurance is a secondary insurance. Every Medicare patient should be filling out a Medicare COB/2ndary insurance questionnaire which is supposed to help staff work their way through the multiple little nuances in the Medicare rules. I have attached the version of this questionnaire that I use in my office. It helps you to determine if Medicare is primary or secondary. It helps ascertain if there is an employer sponsored plan that is applicable to the patient as well as whether the patient has contracted with a Medicare Alternative Plan. Hope this helps. There are other layouts of this form available from multiple sources and some practice management has this screener built in when you are entering a Medicare patient. Dr. Beth Sullivan, DO From: [mailto: ] On Behalf Of Adolfo TeranSent: Friday, March 16, 2012 11:21 AMTo: IMPSubject: co-pays Hello and good morning.Today I am the one asking ( Ardiana is hesitant to do it since her last question, I think I have thicker skin).I am finding that when we have medicare and a secondary insurance, we dont ask for a copay when medicare is the principal insurance.Today I found out via gateway that we were supposed to ask for the copay of the secondary insurance.How is this done? I am thinking about sending the patients a bill for the copay. thanks, AdolfoPS: Thanks to about the link that you sent me.

1 of 1 File(s)

Medicare 2nd Payer Questionaire.doc

[Guest guest]

I am also attaching copies of the 2 handbooks Medicare patients are sent each year explaining how payment responsibility and premiums are determined.  I thought this information might help some of you out.  These handbooks usually come out in November for the coming year.  This year they came out in October since the open enrollment period was moved up. Dr. Beth Sullivan, DO From: [mailto: ] On Behalf Of Adolfo Enrique TeranSent: Friday, March 16, 2012 11:44 AMTo: Subject: Re: co-pays thanks, I will talk to Ardiana about. She is dealing with that part. adolfo To: " " < > Sent: Friday, March 16, 2012 11:39 AMSubject: Re: co-pays I usually bill it once without collecting the copay, just to make sure that the patient really owes the copay. Then, if i find they do have to pay the secondary copay, i put a note in demographics that says " Pt owes 2a copay for each visit. Collect at time of service. " that way the person that works the front desk (when it is not me) will collect it. E-MDs will show a credit balance on the account until the claim is processed and payments (including the 2a) are posted. There are a couple of ways around that, which I can tell you about if you do not want it showing a credit balance (easiest is to edit the copay amount on the Medicare line in the invoice, but that is not really accurate). If the patient does not have to pay the copay, then I also put a note " no copay due " . I do this for other patients, who, for example, have an HSA that covers their copay after the fact, or when patients have reached their max for the year. Typically, if it is a Medicare Supplemental Plan (Part F), then they do owe the copay. I find that if it is a retiree plan from an employer, often there is no copay. Hope this helps, Pratt Hello and good morning.Today I am the one asking ( Ardiana is hesitant to do it since her last question, I think I have thicker skin).I am finding that when we have medicare and a secondary insurance, we dont ask for a copay when medicare is the principal insurance.Today I found out via gateway that we were supposed to ask for the copay of the secondary insurance.How is this done? I am thinking about sending the patients a bill for the copay. thanks, AdolfoPS: Thanks to about the link that you sent me.

2 of 2 File(s)

Medicare & You 2012 Handbook.pdf

Medicare 2012 Who Pays 1st.pdf