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M
momrocks1962 Asked September 2017

Can a provider who accepts Medicare assignment refuse to see an established patient for not paying their coinsurance before the visit?

I was diagnosed with cancer and had to see a cancer surgeon, when I was asked to pay my coinsurance, I responded to the registrant that I thought that came after the claim was adjudicated. You send me a statement, Medicare sends an EOB, I match them and make payment. She said no, and called someone. This big, burly came down to registration and he intimidated me to pay and told me I had to pay or be escorted out. I paid. I had a follow up the next week and was told that I had to pay, this time I had no extra funds, but I told them I would pay when the bill came. They asked me to leave. Is this allowed?

JoAnn29 Sep 2017
Like said, most Doctors have signs that say co-pays have to be paid and any outstanding balances. Your Health Insurance contract probably says that too. That is what a co-pay is. In my Moms situation. The doctor bills, Medicare pays 80percent of what they consider reasonable charges. Hopefully your supplimental will pay the 20%. With Moms she has to share half of the balance. Sorry you had to go thru this.

Shane1124 Sep 2017
Yes I believe it is allowed if you have a co-pay for office visits. Do you have an additional balance besides your coinsurance? Sometimes if this is the case they want payment on that balance too.
Some of those MD office billing managers can get quite assertive in demanding a payment. That must be a challenging position.

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jeannegibbs Sep 2017
All the clinics that I've used expect the copay before the visit, and have signs saying this. I have never seen someone escorted out, but I think the clinics are within their rights to have such a policy.

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