It's actually better than it sounds, y'all. A claim is simply the legally required documentation that your provider or supplier has to send to Medicare in order to be approved. Please note that the process is different for Medicare alternatives known as "Medicare Advantage" or Part C. They have their own system that more closely resembles the headache and hassle of claims as we know it before we become eligible for Original Medicare.
Original Medicare is a whole new ballgame. I recently interviewed an outpatient speech therapist. She told me she wishes that everyone could have Original Medicare for the sake of therapy. She said the claims and approvals are easy with no guesswork, prior approval or tricky paperwork. "Patients get the care they deserve," she said about patients who have original Medicare. She is referring to the transparent coverage of Medicare. It is completely universal, which means every patient that has Original Medicare is entitled to the same rights that they purchased through a lifetime of Medicare taxes and continued premiums.
Without Original Medicare, patients are subject to delay and denial of care that could make a huge difference in their life and their quality of life. Like any successful program, there are some hiccups or "growing pains" any time someone transitions from one coverage to another. The transition from group employer or individual insurance to Original Medicare is no exception. Some experience "growing pains" when the system is not updated with Medicare as your primary before you use it. The growing pains are worth the benefit that they bring. Most claims will be automatically filed exactly as they should because it is uniform and systematic. Original Medicare files the claim with your medigap also called Medicare Supplement electronically when they receive it from your provider or supplier. Some growing pains are easier with an advocate.
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