Payments > Patient Billing

Medicare / Medi-Cal

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DMK:
I think I've posted this question before but I never got an answer.

In July 2009 Medi-Cal (the public assistance Medi-caid program in California) cut many types of benefits.  Chiropractic was one of them. 

Prior to that, if a patient came in with Medicare primary and Medi-Cal secondary, and you were not a Medi-Cal approved provider, you could NOT collect any money from them.  Not even the Medicare co-pay (since Medi-Cal had a much smaller reimbursement they wouldn't pay the difference anyway).

Now, since Medi-Cal doesn't even allow Chiropractic I am legally obligated to collect the co-pay or face punishment from Medicare. 

The patient's can't understand why I HAVE to collect the co-pay now and that I HAD to write it off before.

Am I incorrect or is it part of responsibility as a Medicare provider to collect the required co-pay? 

I have searched high and low on the Medicare site and the Medi-Cal site and can't get any answers.

Thanks for any help!

Michele:
My understanding is that you are legally required to attempt to collect the Medicare deductible and or coinsurance.  If you attempt to collect but are unsuccessful, you fulfilled your legal obligation.

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