Pharmacy Podcast Network

Pharmacy Compliance Guide Podcast Session 7 Participating or Non-Participating, That is the Question Participating vs non-participating, what does this mean? Participating means that you are accepting the Medicare reimbursement or allowable for each product you bill for. Non-Participating means that you are not accepting the Medicare reimbursement. So participating means accepting Assignment? Yes, you are accepting the Medicare allowable or Assignment. You also agree to charge the patient no more than 20% of the allowable at the time of dispensing. Medicare sends the supplier the reimbursement of 80%, less the 2% sequestration fee. If you know the patient has a secondary insurance carrier, the copay should only be the balance after the secondary payment. This c