Author Topic: Medicare copays  (Read 802 times)

James B

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Medicare copays
« on: December 03, 2012, 02:47:40 PM »
Newbie biller with a quick Medicare question.

We billed a patient for a 90862 visit. Charge was $150, Medicare allowed $56.94 and paid $45.55. So is the correct procedure to collect the $24.95 copay + the $45.55 medicare paid and write off the remainder ($79.50). Just want to make sure I'm doing this correctly.

We are out-of-network with all commercial insurances so I typically bill patients for whatever insurance doesn't pay, but I know with Medicare I can only collect the copay Medicare allows plus whatever Medicare pays. Just wanted to run this by you to see if I'm understanding this correctly. I have to verify this with the psychiatrist, but I'm under the impression that Medicare in Connecticut allows us to collect a $24.95 copay for all short sessions.

Thanks!

James

Michele

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Re: Medicare copays
« Reply #1 on: December 05, 2012, 09:07:00 AM »
Are you participating with Medicare or non par?  The Medicare eob should state a patient responsibility.  You are entitled to the Medicare payment plus the patient responsibility.

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