Practice Management Alert

Question: What is the most efficient and least time- consuming way to find out whether a patient has satisfied the Medicare Part B $100 deductible?

Massachusetts Subscriber

 
Answer: Practices should collect deductibles from patients before they see the physician, instead of billing the patient for it later. The advantage in knowing whether the deductible has been met is that youll know what the patient owes for the visit. You can save time and resources, and be assured you get paid, by collecting whats owed up-front.
 
Medicare has no central location to contact to verify that the deductible has been met. If your practice is a primary care office, check your billing records to see if the amount has been satisfied. If your practice is in a specialty, ask the referring physicians to check their records to see if the deductible has been met. Otherwise, you will have to wait for an explanation of benefits from Medicare for the claim to see whether the deductible has been met.
 
If the Medicare patient has supplemental insurance, you may not need to collect the deductible up-front. Many supplemental policies cover the deductible. After Medicare processes its share of the claim, the supplemental insurer pays the difference. You should have all the information on a patients Medicare supplemental insurance, including a copy of the insurance card, so you can bill appropriately.
 
Many insurers require patients to pay a deductible, and it may be stated on their insurance cards. Check whether patients have changed their insurance with each visit, and get a copy of any new insurance card to keep in the patients records.