0
If the physican bills a medicare patient $260 and Medicare approves $250 and Medicare Pays $200. Is the Collectible amount $200? Is the balance due by the patient $50? And is there an Adjustment?
Wiki User
∙ 10y ago
A Medicare adjustment refers to a change or modification made to a Medicare claim or payment. It could be an adjustment to correct errors or discrepancies in the original claim, such as updating the billed amount or correcting coding errors. Medicare adjustments can also occur due to retroactive changes in policies or regulations that affect payment rates or coverage.
Add your answer:
Earn +20 pts
Is medicare claim adjustment code OA ever patient responsibility?
yes
How is billing handled for a patient with dual insurance?
I will use for example someone on MEDICARE. They have paid into their medicare insurance and have both parts (thus eliminating confusion of part a, part b). First the bill is sent to the Medicare insurance provider, who will have an allowed amount and then of that what they will pay. The billing medical source credits what MEDICARE paid and then submits the balance to the 2nd or CO-INSURANCE. As a whole, if MEDICARE pays 90%, the CO-INSURANCE picks up the balance of 10%. These figures were used as an example. You will have to know your own breakdown of what percentage is paid. Remember is is on the ALLOWABLE or APPROVED amount, not the whole billing. Most insurance such as MEDICARE and personal insurance through a work place, have a provider adjustment. Then the % is taken from there. PRIVATE holders of medicare and co-insurance my not have the luxury of an adjustment of cost. And will have to cover what is left.
Is Medicare an HMO?
No, Medicare is a Fee For Service Program, but doctors must contract with Medicare to treat Medicare patients
Do you have to have Medicare Part B if you have a medicare supplemental plan?
Yes; by definition, Medicare supplemental insurance "supplements" Medicare A & B.
Where do you report Medicare fraud?
If you suspect Medicare fraud contact Medicare at 1-800-MEDICARE or visit their website at www.medicare.gov.
Can a Medicare patient elect not to use Medicare?
if you are enrolled in it no, you can decline to enroll on medicare
I am on sosial security medicare,where do i find glasses that take medicare ?
Are glasses covered by medicare?
What does Chevy Trailblazer Medicare offer their clients?
TrailBlazer Medicare is the same to many different Medicare. TrailBlazer Medicare is offering some healthcare with good policies for their customers using the TrailBlazer Medicare.
Where do you file the MEDICARE claim?
Your medicare Physician
Is medicare the nations largest insurance company?
No,, Medicare is not an insurance company. Medicare is a government program.
How does a person get reimbursed by Medicare if they buy an item that is covered by Medicare but bought by the individual?
You will need to contact Medicare and submit the claim directly to Medicare yourself.
Will mayo accept Medicare and supplement?
If a provider accepts Medicare they have to accept a standardized supplement. They may not accept a Medicare Advantage or a Medicare Supplement Select plan.
