Only Medicare participating providers are required to file claims on behalf of Medicare patients.

Question

Quizplus · Accepted Answer

Medicare participating providers are required to accept Medicare's approved amount as payment in full for covered services, but they may still require patients to pay deductibles, coinsurance, and copayments. Non-participating providers may charge up to 15% more than the Medicare approved amount and may require patients to pay the difference as well as any deductibles, coinsurance, or copayments. Both participating and non-participating providers may choose to either submit claims on behalf of patients or have patients submit claims themselves.

Only Medicare Participating Providers Are Required to File Claims on Behalf