What is the nurse practitioner's responsibility for the 20% of charges not covered by Medicare?

The nurse practitioner's responsibility for the 20% of charges not covered by Medicare involves billing the patient for the remainder. This 20% represents the patient’s cost-sharing responsibility under Medicare Part B, which typically requires beneficiaries to pay a copayment or coinsurance for covered services.

When services are rendered to a patient covered by Medicare, the provider submits a claim for the total charge, and Medicare pays its portion. The remaining balance, which in this case is 20%, is the responsibility of the patient as determined by Medicare guidelines.

Billing the patient for this amount is a standard practice in healthcare, as it is essential to maintain transparency in billing and ensure that patients understand their financial obligations. This approach helps to uphold the terms of the agreement between the nurse practitioner and the patient, as well as adhere to the regulations set forth by Medicare regarding patient responsibility.