Medicare Reimbursement Research Paper

2835 Words12 Pages
Medicare Reimbursement Introduction Medicare reimbursement is the payment that the hospital and physicians receive in order to provide services to the patient who can be treated under the Medicare program. The payment directly goes to the billing provider because Medicare insurance does not pay the full amount. Medicare has set rates and pays to the Medicare provider according to the program’s reimbursement rates. The process of payment is accomplished electronically. Medicare advantage plan covers all the services covered by original Medicare except hospice care. In all kinds of Medicare reimbursement plans urgent care and emergency are covered. Medicare also offers extra services for the patients including hearing, vision, dental and wellness…show more content…
Physicians can check the fee schedule and accept an assignment. Any physician who is willing to participate in the Medicare reimbursement program and accepts the assignment must also accept the rates, which Medicare sets as a payment for providing the service. Retrospective payment is reimbursement paid to the provider after health care services are provided. This reimbursement strategy is probably the oldest payment system in health care, based on the historical practice of physicians charging fees for care provided to their patients. One approach to retrospective payment is charge-based reimbursement, in which the provider bills the payer for the full charges of the good or service. The charge-based reimbursement system is similar to many other purchases made by consumers, such as for clothing or…show more content…
It means, suppose if the approved Medicare reimbursement rate for a particular medical service is $100, then a medical provider who accepts the assignment is required to accept that $100 as a full payment for providing the services no matter whether the normal billing rate of the patient is $115. The provider will be only being responsible for his portion of the fee, which is already mentioned in Medicare policies. However, because the provider accepts the payment according to the rate of Medical reimbursement, that’s why the patient cannot be charged for extra $15 which is not paid by Medicare to the
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