Posted by Mary Skinner
In a big personal injury case where the patient has Medicare what is the consequence of a medical provider not even attempting to collect from the liability insurance within 120 days? I believe that some providers have absolutely no intention to collect from liability insurance within 120 days when it's a big case and they take no action at all. Is the consequence that they are limited to the Medicare amounts? Or is there no consequence at all?
Unfortunately, there is no consequence to providers if they choose not to bill the liability insurance. As of May 2006, providers no longer have to bill Medicare. They have the option of either billing Medicare or waiting for settlement at which time they can receive payment for actual charges. With that said, once a provider submits a claim to Medicare, although they can refund Medicare for the claims they have paid, submission to Medicare negates their right to seek actual charges.