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Ask the SFMS: Can I Bill a Medicare Advantage Patient When He/She Chooses to Seek Treatment Outside of the Network?

So, what happens if your practice sees a longtime Medicare patient who has, unbeknownst to you, switched to a Medicare Advantage plan for which your physician is not contracted? Can you bill the patient? Based on information from Centers for Medicare & Medicaid Services (CMS), the answer is yes, but with limits.

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