JeanWest
New
The question is: For Telehealth reimbursement, (G2025) we were told Medicare would have an allowed amount of $92.03.
We send the claim out for $100 and expect a payment to be 80% of the $92.03 allowed amount which would be a payment of $73.63, (20% of $92.03 is $18.40) .
However, Medicare is processing the $100 and doing 80-20% and reimbursing us $72.03 which is $20.00 (or 20% of 100) off the allowed $92.03 amount.
know it's not alot of money we are talking about, but are we understanding this correctly? Or is the MAXIMUM reimbursement $92.03 and we are submitting our billing too low? We have called Medicare and they state they are paying the G2025 correctly.
Can someone please clarify this, while we continue our investigation? Thank you.
We send the claim out for $100 and expect a payment to be 80% of the $92.03 allowed amount which would be a payment of $73.63, (20% of $92.03 is $18.40) .
However, Medicare is processing the $100 and doing 80-20% and reimbursing us $72.03 which is $20.00 (or 20% of 100) off the allowed $92.03 amount.
know it's not alot of money we are talking about, but are we understanding this correctly? Or is the MAXIMUM reimbursement $92.03 and we are submitting our billing too low? We have called Medicare and they state they are paying the G2025 correctly.
Can someone please clarify this, while we continue our investigation? Thank you.