Medicare Patients In Auto Accidents

Here are some basic things you must understand about billing Medicare for services to a patient that is or may be covered by liability insurance:

  • Any liability coverage is the primary coverage – Medicare is secondary.
  • You must wait 120 days from the date of service before you can bill Medicare (this is known as the “promptly period”).
  • Any payments received from Medicare are conditional. If the liability carrier pays, Medicare will demand a refund (maybe years later).
  • All your claims must be withdrawn from the liability carrier.
  • All your liens/claims against the liability settlement must be canceled.
  • If you are a Non-Par provider in the Medicare program, you must bill at the Medicare rate, not your regular fee.
  • And most importantly, you MAY but are NOT REQUIRED to bill Medicare. Don’t let an attorney coerce you into billing Medicare. It’s to his advantage not yours.

Now, this is just a quick snapshot but our opinion is this; don’t bill Medicare for auto accidents unless there is no other insurance.

Complete details are covered in the Medicare and Personal Injury courses.