Part B Claims Processing

[steveadlman]

I have a client who has Aetna as her supplement. She wants to see a new doctor and they are telling her they will not accept her Medicare Supplement because they do not have a contract with Aetna. To no avail I have talked with the office manager and explained Medicare is primary and that Aetna is her Medicare Supplement. I can't fix stupid, but if my client goes to this doctor and they just file with Medicare will Aetna automatically receive the claim once Medicare approves the claim? Does the doctor's office have to file with both Medicare and Aetna in order for Aetna to pay the 20%.

 

[goillini52]

I have a client who has Aetna as her supplement. She wants to see a new doctor and they are telling her they will not accept her Medicare Supplement because they do not have a contract with Aetna. To no avail I have talked with the office manager and explained Medicare is primary and that Aetna is her Medicare Supplement. I can't fix stupid, but if my client goes to this doctor and they just file with Medicare will Aetna automatically receive the claim once Medicare approves the claim? Does the doctor's office have to file with both Medicare and Aetna in order for Aetna to pay the 20%.

Yes, Medicare will file with Aetna. The Dr. doesn't need to know who she has it with. The Med Supp company doesn't want the Dr. filing with them.

 

[cedwards]

I can't tell you how many times we had that conversation with agents and doctors' offices when The Duck rolled out their Medsup.

 

[vic120]

I can't tell you how frustrating it is when the office girl is soo confident and arrogant about it too

Most times I am able to overcome,I did have one I had approved with new era, saving around $100 per month, got scared by the office girl who was soo arrogantly sure that she would not be covered with the new sup, The woman got scarred and cancelled new era

the shame about it this woman had very little left over after paying medical costs and could have really used the money

 

[lcms]

I have had the office girls do the same thing but after you get the client and Aetna or whichever supplement on a conference call it settles!

 

[somarco]

office girl

Office girl?

Are you stuck in the 60's?

 

[NIAMAN]

I can't tell you how many times we had that conversation with agents and doctors' offices when The Duck rolled out their Medsup.

The Duck-now there is a sore subject- They got in the Med Supp market just long enough to get some policies on the books, then pulled out and rates start climbing. Just moved my last one with them and never again!