Medicare - billing question

[Guest guest]

All: (Hopefully Bill)

We have a patient coming from TN who has a non-par Medicare

Advantage plan. I recall reading somewhere, sometime, that a provider cannot

hold a patient responsible for full charges if they are Medicare eligible.

The Question:

If the plan would deny due to non-par / non-authorized, would

the patient only be responsible for the Medicare allowable payment?

Thank you,

Shellie Bush

Sr. Payor Contract Analyst

UPMC / Payor Contract Services

Quantum I, 1st Floor Suite 079.2

phone

fax

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