Medigap & Excess Part B Charges

[sman]

Excess charges are frequent in States where they are allowed. Is there a specialist in NC that accepts assignment? Hah, good luck.

I just did a quick search for Charlotte selecting only Endocrinology. It showed 52 Endocrinologists who accept Medicare assignment within 15 miles of Charlotte, NC. Doesn't seem like that tall of a task.

Medicare

 

[bill3173]

I just did a quick search for Charlotte selecting only Endocrinology. It showed 52 Endocrinologists who accept Medicare assignment within 15 miles of Charlotte, NC. Doesn't seem like that tall of a task.

Medicare

Didn't realize you were in Charlotte and on Medicare seeking an endocrinologist. I should have just spoken for my clients. I have three written recently gi that are seeing specs regularly: a Radiologist, pulmonologist and cardiologist, none of which accept assignment.

Of course this has nothing to do with your search, so I'll withdraw the remark.

 

[GreenSky]

Didn't realize you were in Charlotte and on Medicare seeking an endocrinologist. I should have just spoken for my clients. I have three written recently gi that are seeing specs regularly: a Radiologist, pulmonologist and cardiologist, none of which accept assignment.

Of course this has nothing to do with your search, so I'll withdraw the remark.

Just want to be sure we're on the same page. Are these doctors receiving payment directly from Medicare and the supplement?

Or do they wait for the patient to be reimbursed and then expect payment from the patient?

Rick

 

[yorkriver1]

Didn't realize you were in Charlotte and on Medicare seeking an endocrinologist. I should have just spoken for my clients. I have three written recently gi that are seeing specs regularly: a Radiologist, pulmonologist and cardiologist, none of which accept assignment.

Of course this has nothing to do with your search, so I'll withdraw the remark.

Do you favor the 3 Medigaps F & G (incl. F/Hi Deductible F as 2) that cover Part B Excess?

 

[sman]

Didn't realize you were in Charlotte and on Medicare seeking an endocrinologist. I should have just spoken for my clients. I have three written recently gi that are seeing specs regularly: a Radiologist, pulmonologist and cardiologist, none of which accept assignment.

Of course this has nothing to do with your search, so I'll withdraw the remark.

I'm not in Charlotte nor am I on Medicare or looking for an Endocrinologist. You implied that it was hard to find a specialist in NC accepting Medicare assignment. I found 52 in a matter of minutes for one specialty in one city. Point being, it may not be as difficult as you think.

 

[bill3173]

Just want to be sure we're on the same page. Are these doctors receiving payment directly from Medicare and the supplement?

Or do they wait for the patient to be reimbursed and then expect payment from the patient?

Rick

Good question, it can work either way, but it is customary for the provider to wait and be reimbursed by Medicare, however, I did have one case where they demanded payment up front and the patient had to file the claim directly.

In another case, the client was asked to pay the excess charge, and he called me on it, after he paid it. Fortunately we were on the phone, and he couldn't see how red my face turned, however, when I called the Doc's office, the billing clerk assured me that it was a mistake and they were sending him a check.

With Medicare, I don't see much of anything other than when stuff like this comes up, because I rarely sell anything other than plan F. Most of the time, the person doesn't have to deal with anything at all.
- - - - - - - - - - - - - - - - - -

Do you favor the 3 Medigaps F & G (incl. F/Hi Deductible F as 2) that cover Part B Excess?

Yes, 97% F, and 3% Hi F and G. I'm writing my 2nd hi F tomorrow, and I've already written my 2nd G, so I'm finished with those plans for the year.

 

[GreenSky]

Good question, it can work either way, but it is customary for the provider to wait and be reimbursed by Medicare, however, I did have one case where they demanded payment up front and the patient had to file the claim directly.

If the provider doesn't accept assignment then Medicare will not pay them directly. If as you posted they are reimbursed by Medicare then they damn well not be charging anything excess of 100% of allowable.

Rick

 

[somarco]

I did have one case where they demanded payment up front and the patient had to file the claim directly.

I am under the impression the provider is required to file claims with Medicare regardless of whether they accept assignment or not.

How is the patient supposed to know how to file a claim with Medicare? How do they file with the gap carrier?

 

[DS4]

I am under the impression the provider is required to file claims with Medicare regardless of whether they accept assignment or not.

You are correct..................

 

[GreenSky]

You are correct..................

Why is it that you never say that to me?

Rick