Q: My doctor’s office sometimes asks me to sign a release saying if Medicare doesn’t pay it I’ll be responsible. Can you explain why?
A: Doctors’ offices often ask Medicare beneficiaries to sign a form agreeing to pay for medical care if the provider thinks Medicare does not cover the treatment being provided.
Medicare pays only for services and treatments it calls “medically necessary.” Regulations say that if the beneficiary knows or could reasonably be expected to know that Medicare would not cover the service or treatment prescribed, liability for the charge rests with the beneficiary.
Therefore, the service provider must notify the beneficiary in writing before treatment that Medicare likely will not pay for the services. The provider must explain why the charge may not be covered. Also, the notice must give the patient an idea of why the provider thinks Medicare may deny payment.
This procedure lets the patient make an informed decision about whether to go ahead with the service and possibly have to pay out-of-pocket. The requirement for advance notice is not satisfied by a signed statement that merely says the patient agrees to pay if Medicare denies payment.
It also is unacceptable for a health care provider to issue a general notice saying Medicare denial of payment is possible or that the provider is never sure whether Medicare will cover the prescribed service.
Providers should not give such notice unless they have genuine doubt about the likelihood of coverage. Giving such notice to all Medicare beneficiaries is unacceptable. If you get such a notice and don’t understand the reasons, ask for a detailed explanation.
As with any document you sign, ask for a copy of any notice you sign.
If you think you received an improper notice or want to appeal an advance notice, submit a request in writing to Medicare.
Q: Will Social Security payments stop being available in check form?
A: Yes. Those new to Social Security no longer may get payments of their benefits in check form. When enrolling, they may have their benefits deposited directly into a bank or credit union account or put on a prepaid debit card.
The change took place this year. This also applies to most other types of federal payments, including veteran, railroad retirement and Supplemental Security Income benefits.
Those who currently get their benefits in check form can continue to receive paper checks until March 2013. Then they must change to direct deposit or a debit card.
Eliminating payment by check will save the government millions of dollars and be a much safer way to receive benefits.
Today: “Long Term Care Insurance — Do You Need It?” seminar. 7 to 8:30 p.m., 3900 Avenida Simi, Simi Valley.
May 31: “Maintain Your Brain” seminar. 3:30 to 4:30 p.m., Senior Concerns Day Center, 401 Hodencamp Road, Thousand Oaks. For information or reservations, call 497-0159.
June 3: The Love Run. Registration, 6:30 a.m.; 10K run, 7:45 a.m.; 5K run, 8 a.m.; 1K and Betty Berry Brigade run/walk, 9:15 a.m. For information, call 497-0189 or email firstname.lastname@example.org.
June 7: “Healthier Living: Managing Ongoing Health Conditions” six-week program starts. 9 to 11:30 a.m. For screening and registration, call 495-6250 and ask for Brenda.
June 7: Senior of the Year Award. 5:30 to 8:30 p.m., Goebel Senior Adult Center, 1385 E. Janss Road, Thousand Oaks. Tickets are $6 and can be obtained at the Goebel Center.