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Practice Management Alert

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Medicare as Secondary Payer

Published on Tue Apr 21, 2009

Question: Getting Medicare to pay when it is the secondary payer is difficult. Can we just stop billing Medicare and collect from the patient instead, having the patient file the secondary claim? Arizona Subscriber Answer: You should not bill the patient directly. If the patient has Medicare as his secondary insurance it is illegal for you to bill him and not Medicare. When Medicare is the secondary payer, you are still restricted to the rules and regulations governing the billing and collecting for services based on your contract agreement with Medicare. Keep in mind also that under no circumstances can you collect more from the patient than Medicare allows for the service, even if Medicare is secondary. Private payer difference: If the patient has a nongovernmental program as his secondary coverage, you may bill the patient and let him submit the secondary claim. If you are having trouble with your [...]
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