Re: co-pays [1 Attachment]

[Guest guest]

The only problem that this form doesn't address are all of theMedicare Advantage plans that you now bill instead of Medicare.  And the patients don't alway understand the difference between a MA plan and Part F.

Pratt

 

[Attachment(s) from Beth Sullivan included below]

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 Teran

Sent: 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.