What is the difference between part A and part B explanation of benefits forms?
Part A covers inpatient hospitalization and part B covers outpatient and physician services.
Will Medicare cover my outpatient procedure?
Yes. Medicare will pay for medically necessary acute care services ordered by your physician. Many services must meet medical necessity. In some cases you may even be required to sign an Advance Beneficiary Notice (ABN) indicating that you have been informed that Medicare will not cover the costs of certain services.
Do I have to sign any forms before the hospital can bill Medicare?
You will be asked to sign a consent for treatment form each time you receive services. You will also be asked questions each time you receive services that Medicare requires.
I have health insurance in addition to Medicare coverage. Will the hospital bill that insurance company also?
Yes. Provide the information at registration about your additional health insurance and that insurance company will be billed after Medicare has made its payment.
Should I pay the balance that is listed as "your total responsibility" on the explanation of benefits form?
No. You will receive a bill from the hospital which will show the balance you owe. There may be more than one insurance that has to be billed before you are responsible for the balance.
What should I do with the explanation of benefits form?
Keep the forms you receive from Medicare until all your medical claims have been paid in full including secondary or supplemental insurance if applicable. If a balance is due from you, you will receive a statement from us.
Will I have to pay any money for my hospital visits?
As a Medicare patient, you could be responsible for some significant charges that are related to, co-insurance, deductible and non-covered charge amounts. If you do not have a secondary or supplemental insurance coverage, please contact Patient Financial Services at 912-369-9404 or visit us in the business office if your medical bill is a financial hardship.
Why am I being charged for the pills, inhaler, ointments, etc. that I normally take at home?
These are called "self-administered drugs". Medicare has never covered self-administered drugs if they are provided in an outpatient setting (which means you were not admitted to the hospital as an inpatient).Since these are considered an excluded service, the hospital must bill you - the beneficiary.
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