This is how Medicare Works now:
See if You can Follow Along with This Scenario
Hypothetically, Patient A makes three office visits this year at $50 per visit. Medicare will only pay for $40 per office visit. If Dr. B accepts the assignment, he/she will bill Patient A $80 for the first two office visits. On the third office visit, Dr. B will bill the Medicare carrier for $40. The Medicare carrier will then send Dr. B a check for $16 (80% of $20 [$20 being the amount over the $100 annual deductible]) and Patient A will be liable for the remainder. If Dr. B does not accept the assignment, Medicare's allowable charges will be 5% less than for participating physicians. In this case, Medicare would only allow for $38 (95% of $40) per office visit. Moreover, Dr. B cannot bill Patient A more than $43.70 (115% of $38) for the office visit even though his/her usual charge is $50. Thus, for the first two office visits, Patient A would pay Dr. B directly. On the third office visit, after recognized annual charges now at $114 ($38 x 3), Patient A would receive a check for $11.20 (80% of $14) from Medicare and would be personally liable for the remainder (total bill up to $131.10 [$43.70 x 3]). Any subsequent physician services used by Patient A during that year would be charged at a rate of 115% above the allowable Medicare service-related charge, with Medicare paying 80% of the charge.
Okay Doctors... under the New and Improved Obamacare you'll need a few more Office Staffers to keep track of all this... and as a bonus we are going to cut your pay as a way of thanking you for participating.
Yeah Doctors are going to do that!
Doctors are simply going to walk away from Medicare in Droves. There isn't any money in it now... and it's going to get much much worse. Government run insurance is a logistics nightmare. It's no wonder there is $54 Billion in fraud. Who can keep track of all this and still try and run a practice where they actually see patients?
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