Most of the providers in our office are in-network participating providers with Medicare. This means that we submit claims to Medicare, and receive reimbursement directly for covered services according to the terms of your benefits plan. It also means that we accept Medicare’s allowed fees, and that we do not then balance bill you for the difference between our usual fees, and Medicare’s lower allowed fees.
It also means that we accept whatever fee reduction/discount Medicare may impose, according to the terms of our provider contracts. You are not balance-billed for the difference between our usual fee, and the reduced fee allowed by Medicare.
If you have a Medicare Supplemental (or, Medigap) plan, Medicare will automatically submit the secondary or supplemental claim after they have completed their initial processing of the claim. In most instances, your Supplemental plan will cover whatever co-insurance or deductible amounts were remaining after Medicare’s initial processing of the claim. You are financially responsible for any co-payments/co-insurance, deductibles, and non-covered services might remain after claims are processed by Medicare and any Supplemental plan you may have..
Because Medicare requires a referral or Doctor’s order for certain services, such as neuropsychological testing, you should check with your plan administrator or call the Customer Service number on the back of your insurance card to see if a referral or Doctor’s order is necessary before to your first appointment.