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New CMA resource clarifies prohibitions on balance billing Medi-Medi patients

September 09, 2016
Area(s) of Interest: Payor Issues and Reimbursement Practice Management 

The California Medical Association (CMA) often receives questions from physician members regarding the ability to collect the 20 percent that Medicare does not cover when the physician is not a Medi-Cal provider, but provides services to Medi-Medi (Medicare/Medi-Cal) patients. 


Both state and federal laws provide broad protections to such individuals and prohibit billing a Medi-Cal patient in most circumstances. Running afoul of these laws can put you at risk of a CMS audit and sanctions.


CMA has created a new resource on this topic, “Ask the Expert: Billing Medi-Medi Patients,” free to membershere.

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