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Rakhi Vasavada
Rakhi Vasavada, Financial and Legal Consultant
Category: Finance
Satisfied Customers: 3856
Experience:  Graduated in law with Emphasis on Finance and have have been working in financial sector for over 12 Years
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Customer Question

Im searching for regulation under the healthcare act which confirms that medicaid and medicare have to pay the provoider who performed the service

LBJ chicago
Submitted: 1 year ago.
Category: Finance
Expert:  Rakhi Vasavada replied 1 year ago.

rakhivasavada :

Dear Friend, Hello and welcome...

rakhivasavada :

Kindly be online for a while, as I prepare your reply...

rakhivasavada :

To begin with, kindly note that Medicare / Medicare is not obligated to pay ALL to the one who performed the service. This is something that one needs to know beforehand.. Let me explain.

rakhivasavada :

Note that, before your care begins, the agency should tell you how much of your bill would be paid to the one who performed the service. You are also supposed to be told by the agency what you are and how much you are covered. And how much you are NOT covered and what you will have to pay by yourself.

rakhivasavada :

This is usually conveyed in writing and orally both.

rakhivasavada :

Having said this,

rakhivasavada :

It is ONLY the approved balance that is paid and NOT ALL. You are paid for only what you are covered for.

rakhivasavada :

It is usually Medicare / Medicaid that makes decision about payment. It is the agency which sends the claim. You have right to have agency bill medicare for your care, but ultimately the decision is taken by medicare.

rakhivasavada :

Am I making myself clear ?

rakhivasavada :

Are you there friend ?

Customer :

This not an answer . I owned nursing homes which I sold the state of Illinois and medicare were 6 months behind in payments the federal government and the state were obligated to pay those claims to the provider who redered the service by statue I need to locate that statue.

Customer :

LB

rakhivasavada :

Ok, so your question is from that angle...

rakhivasavada :

Kindly be online for a while...

rakhivasavada :

I am searching, I may take little longer. I appreciate your patience. Kindly be online for a while...

rakhivasavada :

I am sorry, but I am unable to find that Statute. The best thing would be to contact local office, but that would be of little help.

rakhivasavada :

Sorry I could not help you. I shall opt out and see if someone else can help you with.

Expert:  Rakhi Vasavada replied 1 year ago.
Dear Friend,

I have already opted out of this so that other expert can assist you with. This is more of a legal question and I shall do the needful from my end to to try and change the category of this.

Warm Regards

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