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Medicare

Marilyn Posted Mon 25th of January, 2016 13:27:02 PM

Patient has Medicare but per eligibility it's stating an auto insurance
is primary, Medicarre secondary but services provided does not have anything to do with auto related. Is there a modifier to use to let Medicare know that the services being rendered is not auto related?

SuperCoder Answered Thu 28th of January, 2016 00:18:50 AM

You cannot select Medicare or Medicaid as your primary health insurer for auto accidents. However, Medicare or Medicaid may provide coverage on a secondary basis, such as when the costs of your care exceed the personal injury protection limits in your auto policy.
Also, the patient has no fault or liability insurance. So, no-fault insurance or liability insurance pays first and Medicare pays second, if
appropriate.
If doctors or other providers are told you have a no-fault or liability insurance claim,
they must try to get paid from the insurance company before billing Medicare.
However, this may take a long time. If the insurance company doesn’t pay the
claim promptly (usually within 120 days), your doctor or other provider may bill
Medicare. Medicare may make a conditional payment to pay the bill, and then later
get back any payments the primary payer should have made.

Please refer to the following link for further queries.
https://www.medicare.gov/Pubs/pdf/02179.pdf

Marilyn Posted Wed 17th of February, 2016 23:59:09 PM

The visit is for mental health office visits. I still am having trouble with Medicare member to understand that since there's no Part B, Medicare will not cover the office visits but that the BCBS will. Is there a link that explains this situation?

SuperCoder Answered Fri 19th of February, 2016 00:05:57 AM

I hope the following link will be helpful to you :
https://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/how-medicare-works-with-other-insurance.html

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