Rank: Guest
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Hi, it is my understanding that under QMB, I can not charge the patient any copays or deductibles. Considering the already low reimbursements for OAT.... making one under QMB, the reimbursement is likely lower than my cost to provide the treatment. I am a medicare non participating provider, do I have to treat this patient?
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Rank: Administration
Joined: 11/21/2012(UTC)
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Hi Guest! Yes you are correct, here is a link to some additional informationo on the QMB program: https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/QMB.htmlIt is stated: "Medicare providers and suppliers may not bill people in the QMB program for Medicare deductibles, coinsurance, or copays, but state Medicaid programs may pay for those costs." It is my understanding that as a Medicare provider/supplier you are required to submit the claim for any services rendered, but I am not quite sure about your ability to accept the patient or not. I would think there would probably be some type of language in Medicare policy indicating that you cannot accept or not accept patients based on reimbursement rates, but I could be mistaken, I have been unable to find any language to confirm or deny this in my searches today. Hope this helps!
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