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The $20 is not a copay. It's the 20% of allowable for the office visit charge only with a maximum of $20. It could be as low as $12. When the doctor collects $20 they may very well be over collecting. Before I would pay the $20, I would ask the office how much Medicare allows just for the office visit code. Unless they say $100 or more, the "copay" won't be $20. Other services provided have no bearing on the cost. Rick
I don't get why they didn't just make it a copay rather than a coinsurance with a $20 cap, especially since they call it a copay. Given that at check-in, the normal time a copay is collected, the front window staff has no idea what the cost share will be, you're right they are likely to over collect, which they're not allowed to do.
I write a lot of N and my clients tell me the copay is usually not collected at time of service. When I present N I tell prospects it's called a copay but it doesn't work like the kind they're used to.
That's because the government group that made the rules doesn't understand the definition of "co-pay" which is usually a pre-determined amount for a service. Plan N really deals with "coinsurance" and is back billed. My clients receive bills in odd amounts like $8 or $13. The only thing the plan specifies is "up to" $20 for a physician's visit. Very confusing for clients who have been used to "copays" in regular group plans or other types of managed care.
That's because the government group that made the rules doesn't understand the definition of "co-pay" which is usually a pre-determined amount for a service. Plan N really deals with "coinsurance" and is back billed. My clients receive bills in odd amounts like $8 or $13. The only thing the plan specifies is "up to" $20 for a physician's visit. Very confusing for clients who have been used to "copays" in regular group plans or other types of managed care.
The $20 is not a copay. It's the 20% of allowable for the office visit charge only with a maximum of $20. It could be as low as $12.
When the doctor collects $20 they may very well be over collecting.
Before I would pay the $20, I would ask the office how much Medicare allows just for the office visit code. Unless they say $100 or more, the "copay" won't be $20. Other services provided have no bearing on the cost.
Rick
I would but I like my clients too much to do that to them.Just sell Plan F and you can forget this mumbo Jumbo.
Just sell Plan F and you can forget this mumbo Jumbo.