Payments > Insurance Payments

Non Participating with Medicare

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DMK:
If I'm not mistaken, you can then charge the patient the difference between the allowed amount and your fee.  Medicare pays what they would pay PAR, the patient pays the rest.

Michele:
You can only charge up to the limiting fee though.  Not your fee.  The limiting fee is 10% more than the oon allowed amount so it is only 5% more than the in network.  Personally I don't see why a provider would be oon.  However, that is just my opinion.  I know drs that are oon, I just personally don't get it.  IF I were a provider, (which I am not!!!!) and I were going to be a Medicare provider, I would chose to participate.

Again JMO.

DMK:
I completely agree!  Medicare can be tough at first, but once you learn their rules, they are the easiest to deal with.  You know what they pay, and what they don't, and you can count on your money like clockwork. (We'll see how long that lasts, but I've been doing this for 12 years and, so far so good!)

This is one insurance that I make sure I KNOW about.  If you can tell the Medicare patients right up front what to expect they will love you.  Screw it up and they tell 20 friends!

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