Monitoring FAQs
1. Do I have to submit claims for patients that have Medicare as a secondary insurance?
Yes, if you have a copy of the Explanation of Benefits (EOB) from the beneficiary's primary insurance, then you are required to submit a secondary claim to Medicare. If you did not receive an EOB directly from the primary insurance, but the beneficiary provides you with a copy of the one they received, you are required to submit a claim to Medicare.
2. How do I know that a patient has Medicare?
You should ask your patients each time they come to the office. We suggest that you place a statement on forms that the patients fill out, "Do you have Medicare? ___Yes ____No." This statement helps to cover your liability for submitting claims, if the patient fills it out incorrectly. Make sure the form is dated.
3. Can a beneficiary submit a claim for denial when their doctor has opted out of Medicare?
No, this can create a violation of the opt-out agreement for the provider.
Page Last Updated: Wednesday, 30-Dec-2009 10:44:30 CST
