Umm,,I may be wrong but it is against the law to bill you upfront for a visi covered by medicare unless you have signed a contract with the doc who has opted out of medicare and that contract has been approved by the feds. Then the doc can charge his usual fee but you do not pay up front.
Docs can opt out and make individual contracts with patients but very few do it.
And they can bill you and after medicare pays, bill you the remainder. But the first doc she saw may have been breaking the law if he billed her more than medicare allows.
And the second doc is limited as to his fee too.
The feds make it hard for docs to have a contract with a patient outside of medicare.
Yes you are wrong. You can go to a doctor that is not on Medicare assignment. You pay cash and the doctor is required by law to file the Medicare claim for you. There doesn’t need to be any up front agreement anywhere. The doctors don’t care since they get their cash from you. Medicare send you the amount they will pay for the visit minus the 20% co-pay.
Example using round numbers.
Doctor visit $100, you pay doc cash at the office
doctor files the medicare claim for you
medicare pays $50 for the visit
Medicare sends you a check for $50
You are out of pocket $50 for the entire visit
I did it for years with my mother.
http://questions.medicare.gov/app/answers/detail/a_id/1396/related/1
I forgot....my doctor is the one who first told me this.....that all doctors are required by law to file Medicare claims whether or not they are on assignment.
She used to be an assignment doctor but dropped them many years ago because of the rate of pay and slow pay.