Wiki Medicare Part B Provider / Part A only inpatient stay

[mwoodruff]

Good morning!
I'm investigating an issue and need some insight. A part B provider saw a Medicare Part A only patient in the hospital for initial and subsequent care. Provider didn't realize patient was Part A only. Is there any possibility of getting paid for this? I know with SNF Part A stays, you can work something out with the facility, but is this also a possibility with the hospitals?
Thank you!
Magan

 

[dclark7]

All inpatient stays are PART A, but the services provided by individual doctors are covered under Part B. Are you saying that the patient is only eiligible for or only enrolled in Part A Medicare, because this is a different issue entirely.

If the patient is only eligible for or only enrolled in Part A then any professional services provided by doctors are billed to the patient, unless they have another insurance that will cover doctor's services. You have to be careful with this because if a patient should be Part B eligible and chooses not to take it, some insurance companies will ony pay the 20% coinsurance they would have been responsible for if the patient did have Part B.