If the provider, practitioner, or supplier expects payment for the items or services to be denied by Medicare, the provider, practitioner, or supplier must advise the beneficiary __________ the items or services are furnished that, in the opinion of the provider, practitioner, or supplier, the beneficiary will be personally and fully responsible for payment.

Question

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The provider, practitioner, or supplier must inform the beneficiary before the items or services are furnished that they will be personally and fully responsible for payment if Medicare is expected to deny payment. This ensures the beneficiary is aware of potential out-of-pocket costs ahead of time.

If the Provider, Practitioner, or Supplier Expects Payment for the Items