Frequently Asked Questions
about Medicare Billing

Does Mayo Clinic accept Medicare assignment?
Mayo Clinic is a non-participating provider in the Medicare Program. We do not accept assignment on claims submitted to Part B Medicare except:

• where the law requires us to;
• in the case of documented financial hardship;
• when the supplemental insurance is a contract payer;
• when the patient resides in the state of Minnesota.

When claims are sent to Medicare on a non-assigned basis, the benefits for the services are sent directly to the patient. Mayo Clinic is entitled to bill the patient for the difference between our billed amount and Medicare's approved amount. We do not have to accept Medicare's approved amount as payment in full. Mayo Clinic limits its charges according to the limits set forth by HCFA for the Medicare program. Mayo hospital claims are sent assigned.

How do I file my supplemental insurance after Medicare Pays?
It is your responsibility to file your claim to supplemental insurance for clinic services. Clinic services include those provided by physicians in both the clinic and the hospitals. A claim and filing instructions will be sent to you by Mayo Clinic.

Medicare has two billing parts. Medicare Part A covers inpatient hospital services. Medicare Part B covers clinic services, physician fees and outpatient hospital services.

Hospital Services
Rochester Methodist Hospital and Saint Marys Hospital participate in the Medicare program. If you are hospitalized at Saint Marys or Rochester Methodist, Mayo Clinic files your Part A (hospital inpatient) and Part B (hospital outpatient) claims to Medicare for you. Medicare payments will be sent directly to the hospital. You will receive a "Medicare Summary Notice" from Medicare when they process your claim. If you have supplemental hospital insurance, Mayo files the claim for you.

Mayo Clinic Services and Physician Fees
Mayo Clinic is a non-participating provider in the Medicare program. Mayo files claims to Medicare Part B for you.

If you live outside Minnesota, Medicare payment will be made directly to you and a "Medicare Summary Notice" will be sent to you by Medicare when they process your claim. This usually takes four to eight weeks after the claim has been filed.

The checks may either be endorsed and sent to Mayo Clinic (write "Pay to Mayo Clinic Only" on the back and sign your name) or you may deposit them in your personal account and send us a check for the same amount.

Why are the Medicare checks for my care being sent to me? What should I do with them?
If you live outside Minnesota, Medicare payment will be made directly to you and a "Medicare Summary Notice" will be sent to you by Medicare when they process your claim. This usually takes four to eight weeks after the claim has been filed.

The checks may either be endorsed and sent to Mayo Clinic (write "Pay to Mayo Clinic Only" on the back and sign your name) or you may deposit them in your personal account and send us a check for the same amount.

Does Mayo Clinic do Medicare cross-over?
No, Mayo Clinic is not involved in the Medicare cross-over to supplemental insurance. Patients need to contact Medicare and their supplemental insurance carrier to inquire if cross-over is possible and to sign up if required.