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Video instructions and help with filling out and completing patients request for medicare payment form
Hi there this is Nicole with liberty senior savings thanks for watching our video series entitled 88 Medicare questions in 88 days where we try to answer the most commonly asked Medicare questions I wanted to talk to you today about what is Medicare reimbursement Medicare reimbursement refers to the amount of money that a hospital or doctor will receive in return for providing services to Medicare beneficiaries these amounts which is the Medicare fee schedule is determined by federal legislature and this will this means that they will accept a certain amount of money for each procedure for that service that they prit's a Medicare fee schedule 96% as of the time of this video of doctors and physicians accept what's called Medicare assignment what that means is that they will accept what Medicare offers has paid in full generally it's less than what a private insurance would charge so as of the time of this video 96% accept assignment so that saves Medicare a lot of money only 1% of doctors opt out of Medicare completely and they can charge whatever they like but the majority of the time you will never have to file a claim this is done electronically when you have Original Medicare first the bill goes to Medicare and they pay their portion and if you have a supplement behind it to pick up the difference because Medicare is not designed to take care of all costs it goes on to the supplement company and they follow right behind Medicare they're not allowed to say no as long as Medicare says it's a normal Medicare approved procedure and your doctor says that you need it there's nobody behind the scenes to say no now if you did need to file a claim we have a video a specific video for that but the general guidelines are that you must an itemized bill and you're going to ask for the patients request for medical payments that's a certain form you can get that from your plan you must file that within one year you have to prthe itemized bill and an explanation of why you feel this claim should be paid so there's a specific procedure and follow everything that you see have a look at our video about it we can walk you through it very specifically so when we're talking about Medicare reimbursement we're referring only to the Original Medicare Part A and Part B and then you might have that supplement to pick up the costs if you have Medicare Advantage you are not with Original Medicare and since these insurance companies for specifically the Medicare Advantage receive a certain fee every month you must contact your plan directly and if you're unhappy with that and you don't get what you need you can contact a Medicare beneficiary Ombudsman but we hope this has been informative we're happy to help with anything Medicare please feel free to give us