We have been facing a very difficult period where all medical providers are under the microscope. Medicare took the lead by spending more time and resources in their investigation of fraudulent claims. They have been focusing on providers to ensure that they are fully compliant with the rules and regulations.

As a provider you have the option of registering with Medicare. If you become a Medicare provider you can either bill Medicare directly, as a courtesy for your patient, or you can give your patient the super bill and instruct them to bill Medicare. In either event, Medicare will respond by authorizing an amount for the services provided. In the case of a chiropractic adjustment, the amount can be around $28.00 per adjustment. If Medicare pays 80% of this amount, the secondary insurance company should be billed and should pay the remaining 20%. If the patient does not have a secondary carrier, the patient is financially responsible for the payment of 20%.

What happens if you treat someone who has been in an auto accident and is covered by Medicare? Can you have the patient sign a document, which acknowledges that he/she understands that Medicare will not be billed, but rather, you and the patient have agreed to be paid from a lien? Obviously, this is a way in which you as the provider can bill and receive considerably more money than you would have been paid by Medicare. You have to wait until the case settles or a judgment is rendered. An answer to this question is unclear. One must examine whether or not you as a licensed Medicare provider must in all cases bill your patient through the Medicare system. Do you have a choice when your patient comes to you as a victim of an auto accident?