Consolidating billing medicare


25-Oct-2019 05:50

consolidating billing medicare-47

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Medicare billing works differently for Part A (hospital) services and Part B (medical) services.Hospitals receive a set amount of money for each visit from a Medicare beneficiary that is not dependent on the level of care rendered to the individual.Because there is no direct oversight of Medicare’s billing system doctors, sometimes in concert with patients, bill Medicare for services that were not rendered in order to get a larger reimbursement.Other fraudulent schemes include billing Medicare for durable medical goods such as wheel chairs multiple times for just one chair, and never even delivering the wheel chair.Participating Medicare providers are paid 80% of the Medicare allowed fee while the remaining 20% of the fee is paid for by the beneficiary.

Medicare billing for medications dispensed by doctors in their offices reimburses physicians for those medications using an Average Sales Price.The funds to pay for Medicare services are collected from employers and self-employed individuals.