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Wednesday, November 9, 2011

No Out-of-pocket, PECOS, CMS-855i, Fees

November 9, 2011
Chiropractic Medicare

Dear Doctors and Staff,

1.  No Out-of-pocket Expense - Medicare
2.  CMS 855i or PECOS
3.  Medicare Fees

1.  It is against the law to practice No Out-Of-Pocket expense in Medicare.  If you are a participating provider, you have signed a contract with the Federal Government that you will "accept assignment" on ALL Medicare patients.  The Medicare reimbursement of 80% always comes to the doctor.  However, the doctor MUST collect the other 20% from either the patient or the patient's supplemental insurance.  Only accepting the 80% of what Medicare pays is called No Out-Of-Pocket expenses, which is a breach of Medicare law.

2.  CMS 855i Application or PECOS must be completed by All Chiropractors.  If you have not gone on line and completed PECOS or downloaded CMS 855i off the CMS website and completed...DO IT NOW!  If you do not, there will be NO Medicare reimbursement in the near future.

3.  Our Medicare fees have been posted for 2012.  All have been decreased by about 21%.  We again wait on Congress to move on this issue, the same as earlier this year.  With any luck, we may have our fees restored with minimal increases over 2011.

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