Nonparticipating physicians could only charge a bit over the Medicare 'maximum allowable charge
Routing is also a key consideration, to avoid routing refrigerant piping through smaller enclosed rooms with a lower maximum allowable charge
For non-network providers, the outpatient cost-share is 20 percent of the Tricare allowable charge
, and the inpatient cost-share is $16.
However, the blanket imposition of the maximum allowable charge
will worry every family - and there will be many - for whom it represents a life-altering obligation.
If you bill the patient more than the maximum allowable charge
under Medicare, you lose your license," said Dr.
Family members who use the point-of-service option are responsible for paying the annual deductible of $300 per member or $600 per family, and 50 percent of the TRICARE allowable charge
once the deductible is met.
In most cases, the charge was far less than the maximum allowable charge
, she said.
Once the deductible is met, the cost for additional POS care will be 50% of the CHAMPUS/TRICARE allowable charge
If a medical-care provider does not participate in CHAMPUS but bills more than the allowable charge
, a participant is responsible for this amount as well.