Medicare Part D Reimbursement

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Longhorn08

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If I bill Medicare Part D and the reimbursement doesn't cover my cost, am I obligated to fill the Rx and take the loss?

Before you jump all over me for not knowing, please understand that I came from a clinic for uninsured patients and never had to deal with any claims.

TIA!

Members don't see this ad.
 
legally speaking, you don't have to fill any prescriptions.
 
legally speaking, you don't have to fill any prescriptions.

This.

Just have a solid response to the little old lady of why you won't fill it. Up to you if you want to tell her you don't make money on it.
 
Members don't see this ad :)
If I bill Medicare Part D and the reimbursement doesn't cover my cost, am I obligated to fill the Rx and take the loss?

Before you jump all over me for not knowing, please understand that I came from a clinic for uninsured patients and never had to deal with any claims.

TIA!

This is from a contract I'm reviewing right now.

14) Submission of Claims. Provider and its Participating Pharmacies agree to submit all claims to XXXXX, or its designated Claims Processor/Administrator whenever the Member's Identification Card is presented or on file with Provider unless Member expressly requests that a claim not be submitted to Plan 42 CFR §423.120(c)(3)
 
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