Under the category, do I need this aggravation?

I order medical supplies for my neck from two different providers. Since I am still working, my primary insurance is Cigna and Medicare is my secondary. These supplies are covered by Medicare Part B, but both suppliers REFUSE to submit claims to Medicare because it is my secondary insurance. They would file if primary.

I have contacted Medicare and they state there is no way for me to file the claims myself, that they must be filed electronically by provider with EOB from primary.

Has anyone found a solution to this problem? This is ridiculous. Other than these two supply houses, I am having no problem with drs, labs, etc. submitting to Medicare as secondary. Since these suppliers must be paid by credit card and then submitted to insurance, these providers have no insentive to submit to Medicare and it is me out of the money. I've called numerous times and they still insist they are not required by law to file the claims.

Anybody got any ideas how to solve this one? Just what we need. One more piece of aggravation. Isn't it fun to turn 65. GRRRRRRRRRRRRRRRRR

Take care,
Eileen

Eileen,

Medicare won't pay unless they have an EOB (denial) from the primary. You need to get those suppliers to bill the primary first. Then, when they have the denial in hand maybe they will be more likely to bill. Have you considered changing suppliers to ones who would be more cooperative? These guys sound like meanies.

darcy (Matt's Mom)

Hey Eileen,

I checked because I thought most suppliers who accept medicare charges ARE REQUIRED to bill. Check out this link: http://www.medicare.gov/Basics/FAC.asp

darcy again

Thanks Darcy,
The supplier is submitting to my primary and has the EOB. Primary is paying 70 percent. It is the rest of the bill I am trying to get reimbursed for. Medicare has told me the supplier is required to submit to secondary and I have told them that. They say their contract PROHIBITs them from submitting to secondary.

These are the only suppliers that make the equipment I need, although Cigna now thinks I can walk into a med supply house and buy this RX prosthesis for a quarter of what it costs but that's a different battle.

I will try contacting Medicare on the local number on the link you provided. Last time I was on phone for an hour with them telling me that the supplier has to submit it but they did nothing to make that happen. About the time I was getting transferred to a supervisor, I got disconnected. I work, I don't have time for one hour conversations with Medicare.

Thanks again for your help.

Anybody else have any ideas how to get forms to file to Medicare on your own? Also how do you get address of where to file? Medicare card only has address as Baltimore, MD not even street address. Can't find anything on web site. Will let you know what I find out when I call local number.

Take care,
Eileen

I was just going to tell you what Darcy told you.. I am on medicare and have a primary too. Good Luck

OK! So I finally get through to the Medicare number in NJ for other billing ( if you ever need to go there) and am informed that one can only file one paper claim in one's life time for one incident. I currently have 7 claims from two companies. I am told I have to file a Medicare complaint on both these companies so they 'may be re-educated'. If I do that, I fear they will stop accepting my orders and they are they only ones with the supplies I need.

This is silly. How can I be covered with three insurance companys and not get be able to get rest of bill reimbursed because I cannot submit directly to Medicare. The one supplier doesn't even bill primary insurance unless Medicare so wouldn't even have EOB to submit. This Medicare system needs to allow individuals to file paper claims when suppliers can't or won't.

Eileen