Medicare Resource Center™
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frequently-asked
medicare questions
A collection of frequently asked questions about Medicare – answered by the editors of healthinsurance.org™ and guest experts on Medicare issues.
How does Medicare reimbursement work?
Medicare reimbursement refers to the payments that hospitals and physicians receive in return for services rendered to Medicare beneficiaries. The reimbursement rates for these services are set by Medicare, and often, the rates paid will not cover the full amount of the services provided.
Physicians who review the Medicare fee schedule and accept assignment thus accept the rates set by Medicare. This doesn’t mean the provider must accept all Medicare patients, however, and many physicians will limit the number of Medicare patients they accept.
Because the rates are not acceptable to many physicians, many physicians opt to not be a participating physician. Even then, however, a physician can accept Medicare patients, but can then only charge 95 percent of Medicare’s fee schedule.
Tags: accept assignment, physician reimbursement
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