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The EOB states to write off the charge due to the OBRA law. What is this?

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Alice Scott:
Question
Love your website!  So glad I ran across this.  I have one of my clients asking me this question and I have not been successful in finding an answer.  I am hoping you know something about OBRA law.

A patient who is Medicare aged, but does not have Medicare came in for an office visit.  He has Mail Handlers and must not have worked enough quarters to qualify for Part A and opted out of Part B.  We billed Mail Handlers and the EOB states to write off the charge due to the OBRA law.

We are in Michigan and I can not find anyone in or outside of this state that knows a thing about this type of scenerio.

Thank you for your time!

Renee

Answer
Hi Renee

            Wow this is a first for me too.  I did a little research and was able to find a little info about OBRA but nothing that would explain your situation.  What I would do is call Mailhandlers (specifically the number on the eob) and ask them to explain this denial and to give you the reference to back it up.  It just doesn’t sound right.  I would be curious to hear the response you get!
Good luck

Michele

Tracy:
OBRA laws states that as soon as you are eligible for medicare you loose your OBRA coverage regardless of whether you choose to enroll in medicare or not.
here is a website that explains the laws. Ok it rambles on and you will probable be more confused then when you first started, but at least it will give you some ammo when you talk to the insurance company.


jwww.disabilitybenefits101.org/ca/programs/your_rights/cobra_obra/obra/faqs.htm#_q452

Alice Scott:
Tracy,
Thanks a lot.
Alice

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