Father's deductible, can he be charged twice?

Discussion in 'Medicare Part B' started by xJaniex, Jan 30, 2013.

  1. xJaniex

    xJaniex New Member

    Jan 30, 2013
    Can someone be charged a yearly deductible twice? Or be charged more than what your yearly deductible is supposed to be?

    My father's yearly deductible is $147, he saw the gastroenterologist on 1/29/13 and was charged that deductible when to went to the doc's office. He had to pay that full amount upfront. Okay that's fine since I know he is supposed to pay that every year before medicare helps pay the 80%, but what has me confused is that he saw his primary doctor first on 1/10/13, and when I look up his medicare claims it shows that medicare had already applied $115.84 towards his deductible(although my father wasn't charged that by his primary doc when he went to the office). Then my father had a procedure done on 1/14/13 with an anesthesiologist and it shows on his medicare claims page that $31.16 was applied towards his deductible (my father hasn't been billed that yet either)

    So how is it that he saw two doctors first before the gastroenterologist, but none of the two charged a deductible first? Yet the third doctor was fast to charge the deductible?

    Also why does the medicare claims page show that he was applied a deductible from the first two docs yet he hasn't payed anything when he has stepped foot in their offices?

    What happens if the two first doctors decided to charge him what was applied towards his deductible? Does he have to pay another deductible? I mean he already payed the 3rd doctor the full deductible amount of $147.

    I have attached a word file below so that you can hopefully get a clearer picture of what I am talking about.

    Someone please help, I am so confused about this, thank you a bunch!
  2. Mack

    Mack Administrator Staff Member

    Apr 8, 2011

    You will need to use a .pdf file format for the attachment as word documents are not an allowed attachment type.
  3. mattspits

    mattspits Well-Known Member

    Oct 12, 2011
    First, let me preface this by saying that I don't do Medicare billing, but I am familiar with what the Medicare fees are. My first suggestion is to make sure you keep any and all EOBs or Medicare Explanation of Benefits. They will help you keep track of what is happening. Based on what you stated that Medicare applied 115.84 from his 01/10/13 visit than I would be prepared to receive a bill for that from the doctor. It looks like your specialist charged when they shouldn't have, and your primary didn't charge when they should have. Don't pay anything else to anyone until you have your Medicare EOBs in hand, and can sort out who got paid what.



  4. Maxtor

    Maxtor Member

    Feb 7, 2013
    If I keep in mind properly, once the DOR has accepted the come returning, it isn't a situation of creating an revised come returning. You need someone who knows what they are doing.
    As a begin, I would recommend getting returning to the lawyer who ready the come returning and say, "Fix it!"
  5. doc's wife

    doc's wife New Member

    Mar 10, 2013
    while many doctors charge up front for fear of not getting paid by the patient after the fact, it has always been my understanding you must bill medicare first (as well as most insurances that have a deductible). i have 18 years experience and have never billed a medicare patient until after i receive the explanation of benefits.

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