Frequently asked questions about Medicare billing
Does Mayo Clinic accept Medicare assignment?
Medicare has two billing parts. Medicare Part A covers inpatient hospital services. Medicare Part B covers clinic services, physician fees and outpatient hospital services.
Mayo Clinic is a nonparticipating provider in the Medicare program and doesn't accept assignment on claims submitted to Medicare Part B except:
- Where the law requires Mayo Clinic to do so
- In the case of documented financial hardship
- When the supplemental insurance is a contract payer
- When you reside in the state of Minnesota
Mayo Clinic files claims to Medicare Part A and Part B on your behalf.
When claims are sent to Medicare on a nonassigned basis, the benefits for the services are sent directly to you. The law doesn't require health care providers to accept Medicare's approved amount as payment in full, and providers are entitled to bill you for the difference between their billed amount and Medicare's approved amount. Mayo Clinic limits its charges according to the limits set forth by the Centers for Medicare & Medicaid Services (CMS) for the Medicare program. You're responsible for payment of all billed charges, including those that exceed Medicare's approved amount.
What about Medicare and Mayo Clinic services and visit charges?
Mayo Clinic is a nonparticipating provider in the Medicare program. If you live outside Minnesota, Medicare will send payment and a Medicare Summary Notice (MSN) to you directly. Mayo Clinic also receives a copy of the MSN and will file claims to your supplemental insurance on your behalf. Claims processing often takes four to eight weeks.
Checks received from Medicare should be deposited into your personal bank account, and a personal check for the full amount due should be returned to Mayo Clinic in the envelope provided in your Monthly Statement of Account. These checks also may be endorsed — write "Pay to Mayo Clinic Only" on the back and sign your name — and sent to Mayo Clinic.
What about Medicare and hospital services?
Mayo Clinic Hospital, Methodist Campus and Mayo Clinic Hospital, Saint Marys Campus participate in the Medicare program. If you're hospitalized at Mayo Clinic Hospital, Saint Marys Campus or Mayo Clinic Hospital, Methodist Campus, 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'll receive a Medicare Summary Notice from Medicare when it processes your claim. Payment for Part B claims may be sent directly to you and should be forwarded to Mayo Clinic. If you have supplemental hospital insurance, Mayo Clinic will file the claim for you.
Does Mayo Clinic do Medicare cross-over?
No, Mayo Clinic isn't involved in Medicare crossover to supplemental insurance. You need to contact Medicare and your supplemental insurance carrier to inquire if crossover is possible and to sign up if required.
How do I file my supplemental insurance after Medicare pays?
Mayo Clinic will file claims to your supplemental insurance if you don't have a crossover established between Medicare and your supplemental insurance. Your supplemental insurance may make payment to you directly. Insurance payments can be deposited into a personal bank account, and a personal check for the full amount can be forwarded to Mayo Clinic in the envelope provided in your Monthly Statement of Account.