Part B Excess Charges

[Nikita]

I have written 100's of Med Supp policies many being plan N. i have not encountered any issues regarding part B EXCESS Charges . I do see how G can be a better deal depending on the premium. Has anyone had issues or concerns regarding these excess charges? I know its only 15% that the client would have to pay for the excess charges which is minimal for a Dr Visit but if its a surgery it can be expensive.

Just this week I had an interesting situation come up with regards to excess charges. There is a chiropractor in my area who charges $78 per visit and does bill for excess charges. Medicare pays them $40 and they had been billing their client's Plan F for 20% ($8) and charging the remaining $38 to the client. My client asked me about this and I had to call the insurance girl in the office and explain to her how Plan F and G work. She had no idea that F & G would pay for the excess charges and now she is going to have to go back and rebill all of the past charges for all their other patients. What a mess. The patieints apparently did not have a good understanding of the benefits they had and/or didn't have a good agent to talk to or explain it to them.

 

[G.Gordon]

Makes you rethink your entire life, doesn't it?

I'm calling my attorney tomorrow, firing the office staff, and liquidating my book of bizznezz before all hell breaks loose due to this disaster. Can you imagine when people hear about this?!! I can't believe in all the years of medsupp business and transactions that some legal class action suit, congressional hearing, or attorney general want to be governor has not brought this to the public's attention and done something about it.

I'm double fisting shots of whiskey trying to calm my nerves.

 

[GoPokes]

I'm calling my attorney tomorrow, firing the office staff, and liquidating my book of bizznezz before all hell breaks loose due to this disaster. Can you imagine when people hear about this?!! I can't believe in all the years of medsupp business and transactions that some legal class action suit, congressional hearing, or attorney general want to be governor has not brought this to the public's attention and done something about it. I'm double fisting shots of whiskey trying to calm my nerves.

.

I'm triple fisting shots of whiskey. I feel you're pain

 

[DS4]

Interesting subject. How come I've never heard of excess charges before? Is this a real problem. I'm sick over this.

This is exactly why I only sell Plan f. Why expose your client to possible 10's of thousands of dollars in "excess charges"??
I'm so glad I took Ricks Medicare training.

 

[Nikita]

This is exactly why I only sell Plan f. Why expose your client to possible 10's of thousands of dollars in "excess charges"??
I'm so glad I took Ricks Medicare training.

Plan G pays the same excess charges as Plan F and saves your client $$$$...you should go back and review your Medicare training course.

 

[goillini52]

Plan G pays the same excess charges as Plan F and saves your client $$$$...you should go back and review your Medicare training course.

You'd think they'd know that wouldn't you?


They're just being sarcastic.

 

[yorkriver1]

Here's another billing situation that might be like the chiropractor who needed training in Medicare rules. A doctor's website talks about how he gives the bill to the patient to submit to the insurance carrier. A call to the office reveals the young man answering the phone has no idea about Medicare reimbursement other than that the doc is not accepting Medicare assignment. He had not asked Medicare patients how much they got reimbursed for the almost $500 that was charged for initial 2 hour consult.
He referred me to their billing service, who referred me back. I don't want to get into another conversation where the staff acts like I am offending him by asking a specific question.
If they are not accepting assignment or not balance billing only a small amount-15% of the 95% reimbursement rate=9.5%--learned that here.... then as I understand the system, they should opt out. Then, they have to have the Medicare client sign a form stating they can't bill Medicare, because they won't pay at all. Buzzkill, but it's the law.
Or, is there something I am missing here?

 

[WCMason]

Here's another billing situation that might be like the chiropractor who needed training in Medicare rules. A doctor's website talks about how he gives the bill to the patient to submit to the insurance carrier. A call to the office reveals the young man answering the phone has no idea about Medicare reimbursement other than that the doc is not accepting Medicare assignment. He had not asked Medicare patients how much they got reimbursed for the almost $500 that was charged for initial 2 hour consult. He referred me to their billing service, who referred me back. I don't want to get into another conversation where the staff acts like I am offending him by asking a specific question. If they are not accepting assignment or not balance billing only a small amount-15% of the 95% reimbursement rate=9.5%--learned that here.... then as I understand the system, they should opt out. Then, they have to have the Medicare client sign a form stating they can't bill Medicare, because they won't pay at all. Buzzkill, but it's the law. Or, is there something I am missing here?

Chiropractors cannot opt out of Medicare.

From CMS: http://www.cms.gov/Outreach-and-Edu...oducts/downloads/Chiropractors_fact_sheet.pdf

 

[somarco]

There is a chiropractor in my area who charges $78 per visit and does bill for excess charges. Medicare pays them $40 and they had been billing their client's Plan F for 20% ($8) and charging the remaining $38 to the client.

Those numbers don't add up to the way Medicare defines excess charges.

 

[WCMason]

Those numbers don't add up to the way Medicare defines excess charges.

A lot of crooked chiropractors out there perhaps? Some irony in that.