Question
I know that Medicare beneficiaries can pay out-of-pocket for some services; however, many elderly individuals with significant hearing problems do not have the resources to pay for such services. Are there ways to assist in allowing these individuals to obtain appropriate care?
Answer
Yes. There are actually two provisions. First, if you are a Medicare provider, you can provide care at no charge to a patient who is indigent, even if you provide that same care to other patients for a fee. That is something listed in the Medicare statute as rational for providing free services. Second, when it is a non covered benefit, as some procedures are for us today, as long as no-charge billing is allowed by other third-party payors with which you contract, you can provide that service to a Medicare patient in financial need at no charge. The problem actually lies when the service becomes covered. This is when you cannot begin to give it away for free unless certain criteria are met. Indigence is one of those criteria.
Editor's Note: This Ask the Expert was taken from the live e-seminar. The Potential Risks Versus the Need for a Comprehensive Medicare Benefit recorded 6/16/2011. To access the complete course, please go here.
Kim Cavitt, Au.D. spent nine years as a clinical audiologist and preceptor at both The Ohio State University and Northwestern University and spent two years as the Director of Professional Relations at HearPO. For the past ten years, Dr. Cavitt has operated her own Audiology consulting firm, Audiology Resources, Inc. Audiology Resources, Inc. provides comprehensive operational and reimbursement consulting services to hearing healthcare clinics, providers, organizations, buying groups, and manufacturers who want to be better equipped to compete in the managed care and healthcare arenas. She also currently serves on committees through ADA, AAA and ASHA and is an Adjunct Lecturer at Northwestern University.
