if the patient is a Medicare recipient, is the MD required to bill
Medicare before billing the patient? Please cite reference, thank you!

Hi tracodon,

Question: Is the MD required to bill Medicare before billing the patient?

The answer is "no", but the amount all depends on your physician and
whether or not he "accepts assignment" with Medicare. If he does
accept assignment, he may ask you to pay just *your share" of the bill
as early your doctor's visit. If he does not accept assignment, he can
ask you to pay most or all of the bill as early as your doctor's visit
and then you would wait to get reimbursed by Medicare.

"If you are in the Original Medicare Plan, providers (e.g., hospitals,
skilled nursing facilities, home health agencies, and physicians) and
suppliers are required by law to file Medicare claims for covered
services and supplies that you receive. You should not need to file
any Medicare claims."
* My Provider or Supplier Accepts Medicare Assignment
"You pay your share of the bill (coinsurance and deductibles) to the
provider or supplier. The provider or supplier files a Medicare claim.
Medicare pays its share of the bill directly to the provider or
supplier."
* My Physician or Supplier Does Not Accept Medicare Assignment
"If your physician or supplier does not accept assignment for covered
services, your physician or supplier may require that you pay most or
all of the bill at the time you receive services or supplies. However,
the physician or supplier is still required to file a Medicare claim
on your behalf. Medicare then pays its share of the bill directly to
you."
http://www.medicare.gov/Basics/FAC.asp

Does your doctor or supplier accept ?assignment??
* When doctors or suppliers always accept assignment
Example:
The most Mr. Jones or his Medigap policy (Medicare supplement
insurance), if he has one, will have to pay for this service, supply,
or equipment is $20. He may have to pay it when he sees the doctor or
gets his supplies or equipment."
* Doctors and suppliers who don?t participate in Medicare can choose
to accept assignment on a case-by-case basis.
Example:
The most Mr. Jones or his Medigap policy (Medicare supplement
insurance), if he has one, will have to pay the doctor is $19. The
most he will have to pay the supplier is $20. He may have to pay it
when he sees the doctor or gets his supplies or equipment.
http://www.medicare.gov/Publications/Pubs/pdf/10134.pdf

Participating Physician Directory
http://www2.medicare.gov/Physician/Search/PhysicianSearch.asp


I'm sorry if this isn't the news you were hoping to hear. If you have
any questions or if I misunderstood your question, please post a
clarification request *before* closing/rating my answer and I'll be
happy to reply.

Thank you,
hummer

Google Search Terms Used: medicare site:.gov

answered completely.