RE: Medicare coverage of copays

[Guest guest]

My understanding is if the primary insurance paid more than what Medicare

would have paid if they were primary, then Medicare will not pick up the

balance. It would need to be written off as a " Medicare contractual " .

Medicare coverage of copays

Does anybody know if Medicare covers office copays as a secondary insurance?

I'm getting conflicted answers.

Thanks,

Pat Hogan

Transplant Financial Coordinator

Lahey Clinic

Burlington, MA

Phone

Fax

See our web page at http://www.lahey.org for a full directory of Lahey

sites, staff, services and career opportunities.

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[Guest guest]

Hi..our experience has been that if the primary payer pays >45% there will be no reimbursement from Medicare. For our Medicare secondary patients we bill the primary payer the nominal fee and in the rare instances that we bill Medicare we reduce the fees to fit the medicare fee schedule. Most of the time it is not worth the effort. fran

From: Hogan, Sent: Thursday, July 22, 2004 12:44 PMTo: TFC group (E-mail)Subject: Medicare coverage of copays

Does anybody know if Medicare covers office copays as a secondary insurance? I'm getting conflicted answers.

Thanks,

Pat Hogan

Transplant Financial Coordinator

Lahey Clinic

Burlington, MA

Phone

Fax

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

[Guest guest]

our biller says "Yes, it depends on the allowable of the CPT-Medicare will pay up to the allowable amount."

Medicare coverage of copays

Does anybody know if Medicare covers office copays as a secondary insurance? I'm getting conflicted answers.

Thanks,

Pat Hogan

Transplant Financial Coordinator

Lahey Clinic

Burlington, MA

Phone

Fax

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.

[Guest guest]

I am also getting billers that state the "if the primary pays more that Medicare would allow than they won't pay additionally". Then I get the response that as a 2ndary if they don't "pay it" we should be canceling the copay balance as it is too small an amount to pursue with the pt. Then I get the patient refusing to pay the copay. I have called Medicare x2 and got the same dance around with no accurate answer. I have actually had Medicare pay on a couple and not pay on a couple. Frustrating, especially when patients ask me for the correct answer...

Thanks,

Pat

Medicare coverage of copays

Does anybody know if Medicare covers office copays as a secondary insurance? I'm getting conflicted answers.

Thanks,

Pat Hogan

Transplant Financial Coordinator

Lahey Clinic

Burlington, MA

Phone

Fax

See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.

IMPORTANT NOTICE: This communication, including any attachment, contains information that may be confidential or privileged, and is intended solely for the entity or individual to whom it is addressed. If you are not the intended recipient, you should contact the sender and delete the message. Any unauthorized disclosure, copying, or distribution of this message is strictly prohibited. Nothing in this email, including any attachment, is intended to be a legally binding signature.See our web page at http://www.lahey.org for a full directory of Lahey sites, staff, services and career opportunities.THIS MESSAGE IS INTENDED FOR THE USE OF THE PERSON TO WHOM IT IS ADDRESSED. IT MAY CONTAIN INFORMATION THAT IS PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER APPLICABLE LAW. If you are not the intended recipient, your use of this message for any purpose is strictly prohibited. If you have received this communication in error, please delete the message and notify the sender so that we may correct our records.