If Doctors Bolt Then Is Med Supp Better

[MedSuppPro]

If doctors don't accept assignment, then isn't it better to have a MedSupp with excess charges covered?

Fewer Primary Care Physicians Take Medicare Patients -- Medical Services, Hartford Hospital, American Medical Association -- Courant.com

 

[policy doctor]

Welll yes,,,plan F or G would pick up excess, just remember excess has a cap of 115% of medicare allowable.

But this article is talking about drs. limiting the number of new patients either on Medicare or not. The medicare patients don't get enough reimbursement from Medicare....what I don't get is why the doctor doesn't refuse assignment and ask for full price. then the client would pay the difference between dr's bill and Medicare 80% payment, and get reimbursed partly or wholly from ins co.

Some doctors want the whole bill paid up front, and just assist patient in filing claims.

This nag has been beat to death in some old posts so you may want to scroll. The search tab doesn't always find stuff so scrolling seems to work.

 

[GreenSky]

You've really asked 2 questions:

1) Is it better to cover the excess charges?

Generally it is a waste of money. The extra 15% for an occasional office visit may not justify the additional expense. But if the math works, then yes.

2) If docs don't take Medicare, what should the patient do?

If they don't accept Medicare then it doesn't matter if they have a supplement or not. And a doctor can't take a Medicare patient, charge them up front, and then help them file a claim. Only a provider can file a claim and they are still subject to Medicare's limiting charges. Some doctors cheat the patient by doing just that, but it's illegal.

Rick

 

[policy doctor]

Whoa Rick you saying just any doctor cannot take a medicare patient unless he(dr) is in the Medicare system, even if the doc doesn't take assignment? Am reading pg 16 in 2007 Choosing a medigap policy.

Cripe...and why is it illegal for them to help patient file claim? Some patients can't fill out forms.

 

[GreenSky]

Whoa Rick you saying just any doctor cannot take a medicare patient unless he(dr) is in the Medicare system, even if the doc doesn't take assignment? Am reading pg 16 in 2007 Choosing a medigap policy.

Cripe...and why is it illegal for them to help patient file claim? Some patients can't fill out forms.

Unless the doctor is in the Medicare system, he can't bill Medicare.

According to CMS, only a doctor can file a claim with MEDICARE. (Maybe I would have a different answer if I asked a different CMS employee).

Rick

 

[policy doctor]

Talking to myself here. Yes, of course, the doctor would need an id number from Medicare so they could track their reimbursement to him for that claim(s).
Overview

I'll research that illegal part.

 

[MedSuppPro]

OK, so doctors not accepting Medi patients or accepting assignment is a non subject for you. It’s a broken record. Yet the record plays on…

[FONT=&quot]“[/FONT][FONT=&quot]A 10.6 percent Medicare reimbursement reduction in July and an additional 5 percent cut in 2009… [/FONT][FONT=&quot]“ -- AMA [/FONT]

[FONT=&quot]The article also points out a few disturbing trends. It states that some doctors had accepted assignment and are no longer doing so. It also goes on to state that some doctors are dropping out of some of the MA plans.[/FONT]

Isn’t that why we call this a forum and not google?

 

[midwestbroker]

I only knew of one Dr in the KC metro that did not accept Medicare assignment. I am sure there are more, but they are few and far between.

If you do run into the situation, then I would advise that you call the Dr's office while at the appointment to see how they would handle billing.

 

[policy doctor]

If doctors continue to limit the number of Medicare patients, or just refuse them entirely, it will be a MAJOR concern to all of us insurance people. And i have read the same articles since last fall when they started talking about this.

Plus, I am tryng to find a Medicare doctor for my mother. Surprise...not that easy. So here we have an aging population with a shrinking doctor base. And this has happened to my MA(pffs) clients also....where their provider abruptly quit taking MA plans. What part did Medicare play in that decision, I don't know. Other agents posted the same experience this past fall/winter. I remember seeing your posts so I'm sure you read some of that too.

This could be a dilemma....what we thought was guaranteed may not be....kinda like the almighty dollar is not so mighty anymore.

 

[GreenSky]

If this is a dilemma, wait until we get Obama or Clinton care.

Rick