pain doctor’s being “dropped” from being a Medicare participating provider ?

Just got a letter from husband’s PM doctor. Medicare dropped her?! He’s been going to her for 15 years. I’m so upset. Apparently it’s because she writes prescriptions for pain medication. And she’s she’s a pain management Dr.

Unless they have changed things… prescribers do not have to be a participating provider…

Being a participating provider means that Medicare will pay them directly…

If they are a non-participating provider, it means that the prescriber is obligated/mandated to bill Medicare for services provided to the pt and the Medicare will send the money reimbursement directly to the pt.

Again unless things have changes, the prescriber is prohibited from charging the pt more than 10%-15% higher charge than what Medicare otherwise allows.  The advantage to a prescriber in being a participating provider is that they do not have to worry about collecting monies from the pt. … many pts do not have the resources to pay the full office visit charge at the time they are seen by the prescriber… making potential for collection problems finding out when Medicare sent the money to the pt and then collecting the amount due.










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