Doctor 'opts out' of Medicare

oceanbabyOctober 29, 2007

I am seeing a doctor who has opted out of the Medicare Program and will not submit a claim on my behalf. She has submitted a form to Medicare in this regard. I pay the full amount of the office visit to her. I do have a secondary carrier. Do I have any options? How should I handle? Do I just send a copy of the bill to my secondary carrier and hope for the best? Thanks in advance.

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Unless something has changed (and they change everytime you turn around) she is not supposed to see a person with Medicare unless she files for them.
I am very interested in what happens. Please keep us posted. I think we are going to see more and more doctors deciding to go this route.

Medicare is just not paying enough and the other patients have to be charged more to make up the difference. I did a cost factor study for my son's practice and for the time involved, staff time, supplies and record keeping, billing, etc. It was an eye opening experience!

I guess that about all you can do is to send the form to the secondary carrier. My bet is that if your policy is set up so that they are supposed to pay the 20% after Medicare pays the approved amount, that's all they will pay....and maybe not even that if Medicare isn't filed. If finances are a problem, you might think about finding another doctor.

    Bookmark   October 29, 2007 at 3:49PM
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Medicare advised that they will not pay for services you receive from a provider who has decided to opt out of the program and I cannot file my own claim. I've submitted the claim to my secondary carrier. As this is a doctor I see only every six months I'll probably stay with her.

    Bookmark   November 25, 2007 at 2:50PM
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