Can doctors refuse Med Supps from certain carriers?

[LostDollar]

Yes. But they can’t force you to buy a med supp. If you don’t have your card you just give them your Medicare card. He’s saying they won’t see you if you don’t give them a med supp card. That’s just nuts.
I’m sure if they find out later on that you have a med supp and they want the info they can get it. But you’re not required to hand them a card.
I have one client that i signed up 5 years ago and she just told me she never got a med supp card lol

Can’t understand logic and forgetful...

See quote above. Chazm is saying I said they would not see me if I didn't give them a med supp card. That is not true.

 

[atthewood]

Medicare will send it to the supplement company IF they included the supplement co info on the claim that goes to Medicare. I tell my clients if they have an uninformed doctor's staff, "if after Medicare pays and my secondary pays, if I still owe you anything, I'll be glad to pay it." But it's highly unlikely that $157 is the 15% maximum of excess charges unless there was surgery involved.

 

[goillini52]

Medicare will send it to the supplement company IF they included the supplement co info on the claim that goes to Medicare. I tell my clients if they have an uninformed doctor's staff, "if after Medicare pays and my secondary pays, if I still owe you anything, I'll be glad to pay it." But it's highly unlikely that $157 is the 15% maximum of excess charges unless there was surgery involved.

You're wrong on that. When someone takes out a Med Supp, the Med Supp company notifies Medicare and they set up the cross over. The Med Supp company will get the claim from Medicare...whether the Doctor's office knows who they have ther MedSupp with or not.

 

[MBSC]

Medicare will send it to the supplement company IF they included the supplement co info on the claim that goes to Medicare.

Medicare only sends participating provider claims to the Medigap. The OP states in post #4 that the provider does not accept claim assignment, meaning they are non-participating.

Medicare Claims Processing Manual
Chapter 28 - Coordination With Medigap, Medicaid, and Other Complementary Insurers
Section 20 - Assignment of Claims and Transfer Policy

"Paid claims from participating physicians or providers/suppliers for beneficiaries who have assigned their right to payment under a Medigap policy, regardless of whether or not it is in or from a State with an approved Medigap program, are to result in the transfer of claim information to the specified insurers.

The A/B MAC (B) and DME MAC systems must have the capability to distinguish between claims of participating and nonparticipating physicians/practitioners and suppliers. This is because Medigap assignment of claims and transfer policy does not apply to nonparticipating physicians/practitioners or non-participating suppliers."

Source: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c28.pdf

 

[senior-advisor-indiana]

Medicare will send it to the supplement company IF they included the supplement co info on the claim that goes to Medicare. I tell my clients if they have an uninformed doctor's staff, "if after Medicare pays and my secondary pays, if I still owe you anything, I'll be glad to pay it." But it's highly unlikely that $157 is the 15% maximum of excess charges unless there was surgery involved.

I would wager that $157 is the total cost of the visit. If a dr doesn't accept assignment then they usually have to pay the whole bill up front and then the patient is reimbursed by Medicare and the supp company.