The 2021 annual outpatient (Part B) deductible for Medicare beneficiaries is $203.00. This is a $5.00 increase from last year. Most secondary insurance plans expect the patient to pay the deductible before covering their portion of the Medicare payment amount. The patient is responsible to pay the first $203 directly to their providers.
Additionally, most Commercial insurance beneficiaries who have a deductible begin the calendar year with their full deductible amount due before their insurance plan begins to pay. This means that most practices have more money due from their patients at the beginning of the year than at any other time.
Response to COVID-19 certainly challenged so many of our practices since different payers had unique policies regarding copays, benefits for telepsych services. We encourage you to reverify your patients’ benefits to have the most up-to-date coverage information. Our VOB (Verification of Benefits) team asks specific questions related to cost-sharing and Telehealth coverage. This will help you to know what to expect from the payer and the patient. Keep in mind that many patients have self-funded plans and the cost-share waivers (no copay) don’t apply. We can get that information for you so that you can collect what you should.
Reminder: Mark your claim THV when you have a Telehealth visit. We don’t assume that your session was remote since some practitioners have returned to in-person sessions. This can impact your payment. (Save yourself the $2.25 for submitting a corrected claim).
As a reminder, Health Assets reduced the fee for patient statements (invoices to patients for the amount they owe you) to $2.00 to make it affordable for your practice to send out professional invoices and receive payments from your patients. Please talk to us about setting up a regular patient mailing schedule for your practice in order to receive the full amount owed to you. Practices that send out these invoices are more successful in recovering patient balances.
Check the Health Assets website, www.healthassets.com, for regular updates on changes to reimbursement, billing, and copayments since the playing field is changing as the pandemic is more under control.
We have moved into our new office. Our address is 340 Main St. Suite 6, Saugerties, NY 12477. Our phone number has not changed.
As always, our staff is available to answer your questions about Medicare participation, as well as Medicaid and Commercial Insurance Payer billing and credentialing.
Looking forward to better days in the second half of 2021!
Carmel L Gold, LCSW
Advisor
Health Assets Management, LLC