Confused By "maximum You May Be Billed"

[member]

I'm guessing this is simple (obviously not for me!), but when I read the medicare summary notice for part B, I'm confused by the column, "maximum you may be billed". For example, the service was not approved and the Dr. charged $200 and medicare will pay $0, but "maximum you may be billed" is also $0. Why isn't this the $200 that I owe the Dr.?

Thanks for any help that you can offer!

 

[MBSC]

There can be several reasons for this but a common reason is that prior to receiving the medical service the provider failed to have you sign the "Advance Beneficiary Notice" (ABN) letting you know you would be responsible for the charge. The provider's failure to let you know you would be responsible for the charge results in the provider being responsible for the non-covered service.

 

[member]

There can be several reasons for this but a common reason is that prior to receiving the medical service the provider failed to have you sign the "Advance Beneficiary Notice" (ABN) letting you know you would be responsible for the charge. The provider's failure to let you know you would be responsible for the charge results in the provider being responsible for the non-covered service.

Thanks for that! I bet that's what it is. It's probably a good idea to pay them anyway, but it's surprising that they wouldn't take care of this paperwork in advance to protect themselves.