Carrier Filing of Medigap Claim - Under sure circumstances, after you receive medical services coated by each health care and your Medigap insurance, you'll not ought to file a separate claim along with your Medigap insurance firm to possess payment created on to your medico or medical provider. By law, the health care carrier that processes health care claims for your spaceshould send your claim to the Medigap insurance firm for payment once the subsequent 3 conditions square measurement for a health care half B claim:
- Your physician or supplier must have signed a participation agreement with Medicare to accept assignment of Medicare claims for all patients who are Medicare beneficiaries:
- Your policy must be a Medigap policy: and
- You must instruct your physician to indicate on the Medicare claim form that you wish payment of Medigap benefits to be made to the participating physician or supplier. Your physician will put your Medigap policy number on the Medicare claim form.
When these conditions are met, the Medicare carrier will process the Medicare claim, send the claim to the Medigap insurer and generally send you an Explanation of Medicare Benefits (EOMB). Your Medigap insurer will pay benefits directly to your physician or medical supplier and send you a notice that they have done so. If the insurer refuses to pay the physician directly when these three conditions are met, you should report this to your state insurance department. For more information on Medigap claim filing by the carrier, contact the Medicare carrier. Look in The Medicare Handbook for the name and telephone number of the carrier for your area.