Insurance billing question

[Guest guest]

I will be starting my IMP in the Los Angeles area this summer and have many questions about insurance billing.

I am thinking about not taking medicare but I do enjoy geriatrics and nursing home care (did 6 months training program in geriatrics in Canada). My premise for not taking medicare is their Rules and Regulations sound strangulating.

Question one- if I am non participating, do I have to follow the same RR as a participating doc? If I am non participating, I will have to bill the pt first and then they get reimbursed directly from medicare ( ? at a lower rate, right). If I opt out then the pt gets no reimbursement, correct? Is anyone out there doing nursing home care w/o medicare?

Question two- for private insurance, if I see a pt who has say Cigna and I have not signed up for Cigna, can the pt be reimbursed directly from Cigna? Or does it depend on their plan?

Question three - If I am taking Blue Shield, and for some reason , Blue Shield does not pay me, can I charge the pt an " administration " fee for my hassle with their insurance company? Do some insurance forbid billing pt directly if doc does not get paid?

I am thinking of starting out w just 2 or 3 insurance companies and non participating in Medicare

Thanx in advance for your responses-- M.D.www.elainemd.com