Frank, perhaps you might explain the concept of "assignment" to those who seem to have a problem with this. I would, but you will do a better job than I.
I think too many agents completely miss the point about "Medicare assignment".
Frank, perhaps you might explain the concept of "assignment" to those who seem to have a problem with this. I would, but you will do a better job than I.
I think too many agents completely miss the point about "Medicare assignment".
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Part B assignment rate was 61.5% in 1969, and has been rising every year since.
It is now 99.0%.
See Social Security Bulletin, Annual Statistical Supplement, 8.55, 2005.
My primary issue with AARP is that their DM operation directly competes with agent-sold business. They want their cake, they want to eat it, and then they want to lick the plate.
Personally, I don't like companies that distribute through agents -- and then compete with them by selling direct.
atlantainsguy
It is now 99.0%.
See Social Security Bulletin, Annual Statistical Supplement, 8.55, 2005.
My primary issue with AARP is that their DM operation directly competes with agent-sold business. They want their cake, they want to eat it, and then they want to lick the plate.
Personally, I don't like companies that distribute through agents -- and then compete with them by selling direct.
atlantainsguy
I just spoke with this office, they told me they have "opted out" of any Medicare responsibility. It's not that they do not accept assignment, they have "opted out."
The office has the patient sign a waiver stating the office will not accept any Medicare payment.
They are also not part of any insurance company network.
Have you guys heard of this?
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Yep, I have. One may be able to compare that doctor to an agent who will only sell the policy he/she makes the most commission on with total disregard to whether or not the policy is the best one for the prospect. Well almost anyway.
The doctor is really saying that "I'm not willing to accept the money Medicare will pay, it isn't enough. I want more."
Some think that is a pretty arrogant, greedy position to take. The doctor may be good but, in reality, there are probably others who are just as good or better. I would find another doctor.
Thanks for your input Frank, I agree. It's a tough spot because this Doc comes highly recommended, and my client is looking for an alternative treatment.
They are also willing to pay the $460 visit. Although I'm not sure they would be willing to pay on an ongoing basis.
We'll see what happens.
They are also willing to pay the $460 visit. Although I'm not sure they would be willing to pay on an ongoing basis.
We'll see what happens.
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When the doctor sends a claim to Medicare, Medicare will assign a value to that claim, hence the term "Accept Assignment". If the doctor agrees to "Accept Assignment" then the doctor also agrees to accept that assigned value as 100% payment for his/her services, of which Medicare pays 80% and the Med Supp policy pays the remaining 20%.
If the doctor does not Accept Assignment the claim still goes to Medicare and medicare will "assign a value". It makes no difference whether or not the doctor, it is the same value whether or not the doctor Accepts Assignment.
If the doctor does not Accept Assignment then Medicare will reduce the amount of value by 5%. The doctor can then add the 15% to the reduced amount. Either the insurance company or the individual will have to pay that additional money.
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Medicare Cut’s From A Doctor’s Prospective: Breaking News | Latest News | Current News - FOXNews.com
In the case of paying the $460 out of pocket can the payee now submit the claim to AARP for reimbursement?
I just had some serious medical issues and the doctors I saw in NYC do not deal with insurance companies. $600 office visit, you must pay and then submit it to your insurance company for reimbursment.
How does that work with med supps?
RHCBP
I just had some serious medical issues and the doctors I saw in NYC do not deal with insurance companies. $600 office visit, you must pay and then submit it to your insurance company for reimbursment.
How does that work with med supps?
RHCBP
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Medicare does not allow a patient to bill them. Only a provider may do this. A supplement is just that...it supplements Medicare. No Medicare payment, no supplement. Doesn't work like IFP because it's not a stand-alone plan.
If a provider has opted out of the Medicare system they can't bill Medicare. The only option for a senior is likely cash.
Rick
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Rick, the office told me some of the insurance providers will sometimes re-imburse a small portion of the bill.
They may have been talking about under age 65 health plans.
Or in this case would my client be able to submit to Blue Shield and see if they will pay a little?
They may have been talking about under age 65 health plans.
Or in this case would my client be able to submit to Blue Shield and see if they will pay a little?
