Can doctors refuse Med Supps from certain carriers?

[MrSockMonkey]

How long have you been selling mapd for? I’m in orlando, I live downtown right on Orange Ave, and I sell only about 10-12 apps per month. Of those, 4 are probably med supps. How have you not done any before? How are you presenting them?

Chazm...I think this Medicare stuff is insanity. People have come to me for coverage. Not so many as you have. Still digesting it to see where my place is. While the MAPD plans in Florida are incredible, I feel like I am in a straitjacket or in prison. I am naturally bubbly,passionate and dramatic. Not a good fit for marketing MAPD. Working on it. Thank you for your interest.

 

[MBSC]

....the first time the guy goes to his doctor with his very first Medicare visit, he has to pay $157 out of pocket because his doctor doesn't accept Medicare assignment.

Somethings not right. I can't imagine how someone would owe $157 in excess charges from an office call.

How could they "force you to pay up front" when medicare is 1st payer, has a deductible, and needs to process the claim before it can be determined how much the bene owes?

Medicare and the supplement send payment to the patient on non-assigned claims so the patient usually has to pay the non-participating provider in full up front if they want to be treated.

"When providers do not accept assignment, they can bill the patient for more than the Medicare approved amount and ask for full payment at the time they give the service. Medicare then pays the patient, not the provider."

 

[sshafran]

Correct. The provider bills medicare, then medicare sends the bill to the supplement carrier.

At least 99% of the time it works like a charm.

Now, it doesn't hurt for them to give the provider their med supp card, but its not absolutely necessary.

It is when the doctor's billing clerk says you must provide it.

The problem with LD is that he will latch on to things like this ^ and annoy everyone with his "personal experience." He then trys to prove us wrong.

But he doesn't understand logic and can't comprehend what he reads.

I stand by my statement.

It is not absolutely necessary to give the provider your med supp card. Could they potentially bill you up front? Sure. Could you potentially get hit by lightning? Sure.

But if they do (chances very slim), you'll get reimbursed. Therefore, it is not absolutely necessary for you to give the provider your med supp card. My statement, which he chose to argue against, is a true statement, and should not be argued against.

And if you get hit by lightning, you won't need to worry about any bills.

I hope LD's computer gets hit by lightning so that he can leave this forum.

 

[goillini52]

The problem with LD is that he will latch on to things like this ^ and annoy everyone with his "personal experience." He then trys to prove us wrong.

But he doesn't understand logic and can't comprehend what he reads.

I stand by my statement.

It is not absolutely necessary to give the provider your med supp card. Could they potentially bill you up front? Sure. Could you potentially get hit by lightning? Sure.

But if they do (chances very slim), you'll get reimbursed. Therefore, it is not absolutely necessary for you to give the provider your med supp card. My statement, which he chose to argue against, is a true statement, and should not be argued against.

And if you get hit by lightning, you won't need to worry about any bills.

I hope LD's computer gets hit by lightning so that he can leave this forum.

I even said that I tell this to new and current clients when I switch them from one Med Supp to another...the Med Supp company will get your claim whether the Dr. knows who your Med Supp is with or not. It's just common courtesy to let them know who your Med Supp is with.

Why would you have a problem showing your card to the Dr.'s office? Isn't that why we get I.D. cards?

 

[sshafran]

I even said that I tell this to new and current clients when I switch them from one Med Supp to another...the Med Supp company will get your claim whether the Dr. knows who your Med Supp is with or not. It's just common courtesy to let them know who your Med Supp is with.

Why would you have a problem showing your card to the Dr.'s office? Isn't that why we get I.D. cards?

No problem with it. Only have a problem with LD arguing a point that doesn't need to be argued against.

 

[isaias]

Or what? You can disagree all you want but a doctor will never require you to buy a med supp plan.
You’re saying I can’t walk into your doctors office and just give my medicare card. You’re 100% wrong here bud.
If they insist and I don’t have a med supp, they are turning people away? I doubt it

I recently had a case where they did ask a long time patient to leave. The doctor's staff was adamant that he had to have a specific company and the card had to have a specific line identifying the medical group he belonged to (which happened to be an MAPD plan, and a medical group they don't belong to).

We went to their office and tried to educate the staff on the different types of Medicare coverage but I didn't have a "vendor" agreement with them so I was asked to leave, he was told to change his plan or go somewhere else.

My customer agreed that the staff had no clue what they were talking about but In the end he still went with their recommendation. He had been a patient there for a long time and didn't want to change doctors so he cancelled and now has has much higher medical expenses because of this, but still won't change doctors.

 

[goillini52]

I recently had a case where they did ask a long time patient to leave. The doctor's staff was adamant that he had to have a specific company and the card had to have a specific line identifying the medical group he belonged to (which happened to be an MAPD plan, and a medical group they don't belong to).

We went to their office and tried to educate the staff on the different types of Medicare coverage but I didn't have a "vendor" agreement with them so I was asked to leave, he was told to change his plan or go somewhere else.

My customer agreed that the staff had no clue what they were talking about but In the end he still went with their recommendation. He had been a patient there for a long time and didn't want to change doctors so he cancelled and now has has much higher medical expenses because of this, but still won't change doctors.

I like all of my Doctors, but in a case like this...I'd find another Dr.

 

[LostDollar]

The problem with LD is that he will latch on to things like this ^ and annoy everyone with his "personal experience." He then trys to prove us wrong.

But he doesn't understand logic and can't comprehend what he reads.

I stand by my statement.

It is not absolutely necessary to give the provider your med supp card. Could they potentially bill you up front? Sure. Could you potentially get hit by lightning? Sure.

But if they do (chances very slim), you'll get reimbursed. Therefore, it is not absolutely necessary for you to give the provider your med supp card. My statement, which he chose to argue against, is a true statement, and should not be argued against.

And if you get hit by lightning, you won't need to worry about any bills.

I hope LD's computer gets hit by lightning so that he can leave this forum.

It is not absolutely necessary to give the provider any insurance cards.

 

[sshafran]

It is not absolutely necessary to give the provider any insurance cards.

There you go...

 

[LostDollar]

No problem with it. Only have a problem with LD arguing a point that doesn't need to be argued against.

If it is a point that doesn't need to be argued, then why are you arguing?