Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan’s terms and conditions for payment. Mary Rod

Question

Grace [21]

4 years ago

13

Dr. Elizabeth Brennan does not contract with the ABC PFFS plan but accepts the plan’s terms and conditions for payment. Mary Rod

gers sees Dr. Brennan for treatment. How much may Dr. Brennan charge?

Medicine

1 answer:

Sveta_85 [38] · Answer 1 · 2022-01-16T05:00:27+03:00

Answer:

Dr Brennan can charge Mary Rogers no more than the cost-sharing specified in the PFFS plan's terms and condition of payment which may include balance billing up to 15 per cent of the Medicare rate.

Explanation:

Note that the terms PFFS (Private-Fee-for-Service) refers to Medicare advantages one stands to gain when under an insurance cover.

Thus, according to the terms of the Medicare Private-Fee-for-Service (PFFS), Dr Brennan is restricted to charge Mary Rogers no more than the cost-sharing specified in the PFFS plan's terms and condition of payment which may include balance billing up to 15 per cent of the Medicare rate.