how and what physicians are paid

[keith365]

I have an appointment with a doctor's administrator later this week. I don't think they understand medicare advantage, since I don't see them in any provider directory. Can anyone explain to me how they would get paid if they accepted medicare advantage? And, would it be more or less than the amount they receive from supplements? I basically need a explanation of how doctor's are paid from both types of medicare insurance: Supplements and advantage plans. Who can help?
Thanks!!

 

[TwoCents]

I have an appointment with a doctor's administrator later this week. I don't think they understand medicare advantage, since I don't see them in any provider directory. Can anyone explain to me how they would get paid if they accepted medicare advantage? And, would it be more or less than the amount they receive from supplements? I basically need a explanation of how doctor's are paid from both types of medicare insurance: Supplements and advantage plans. Who can help?
Thanks!!

For the most part for supplements you see the doctor, doctor bills Medicare, Medicare pays its part and the supplement is notified that a claim was filed and they'll process their part to pay the provider. Provider's office might get confused, but they don't have to "take" your supplement like they would for Medicare Advantage.

If you're on a Medicare Advantage, have you checked the plan's provider directory to see if the doctor is in-network. Assuming this is just an office visit and the doctor takes your plan, you should expect to probably pay a copay (flat dollar amount for the visit) and the provider would get additional payment by submitting the claim to the Medicare Advantage company. Check your evidence of coverage book or call your plan or go online!