By Tucker Thompson
More hospitals and medical offices are charging Medicare patients for procedures not covered by Medicare!
Some doctors and hospitals are placing signs in their reception area stating they may run procedures not covered by insurance or Medicare and that the client is responsible for payment. Be aware, Medicare will only pay for Medicare approved procedures. The signing of a form may state you are responsible for these charges, even though you gave the receptionist your Medicare insurance cards. So, please read all medicare forms.
Always read before signing! When checking into a hospital or medical office before any procedures or services, tell the receptionist you only want services paid for by Medicare, unless you are willing to personally pay for services not approved by Medicare. Show your Medicare card, Medicare Supplement card, or your Medicare Advantage Plan card. If the form states you agree to pay for any procedures not approved by Medicare, you may want to cross out and initial that sentence, in addition to signing and dating the form usually at the end of the document. You may also want to ask for a copy of your signed document too.
When you get a bill from the hospital or medical office, check your EOB (explanation of benefits) from Medicare and your insurance company. You may have deductibles or co-pays, depending on your Medicare coverage. If a charge is not approved by Medicare, the charge may be sent to you. Telephone the billing department and ask for a supervisor. If you specifically told the receptionist when checking in that you only wanted procedures approved by Medicare, write down the name of the person you’re talking with in the billing department, and politely explain to them that you only agreed to Medicare approved services. Some billing departments will take the charge off while others will insist you signed the form.
Up to 98% of Medicare claims are filed electronically to Medicare. If you have a Medicare supplement, Medicare then electronically sends the bill to your insurance company. By federal law, Medicare payments must be paid by Medicare to the provider within 10 days after the provider has electronically sent in their bill to Medicare. Because payment from Medicare to providers is so prompt, you shouldn’t be asked to pay out of your pocket before any services, unless you have a co-pay with your insurance plan. If you have an Advantage Plan, the claim should be filed directly to your Advantage Plan insurance company from your medical provider.
