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Medicare
LifeScape treats Medicare patients but does not accept Medicare assignment. Like most healthcare organizations that do not accept Medicare assignment, LifeScape charges fifteen percent above the Medicare allowable. Patients must pay LifeScape directly for their visit at the time of service. As a courtesy, LifeScape submits patients’ claims to Medicare. If the visit was for a “covered service,” Medicare will reimburse the patient at its standard, eighty percent of allowable rate. In most instances, Medicare will submit the remaining balance to the patient’s secondary carrier, if any, for further reimbursement. Responsibility for coverage determination and collection lies solely with the patient.
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If the Medicare allowable for a service is $100, LifeScape will charge the patient $115 at the time of treatment. LifeScape will promptly submit the charge to Medicare and Medicare will reimburse the patient $80. Medicare will then submit the remaining $35 balance to any supplemental insurer that will reimburse the patient according to its policies. |
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