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<blockquote data-quote="Jim Simmers" data-source="post: 390449" data-attributes="member: 2674"><p>So fill in the blanks for me.</p><p>1-who does the medical industry send their invoices/claims to, the insurance carrier/ member may have cost share. Some like hospice for instance go to CMS.</p><p>2-who pays the actual claims sent by hospital. the insurance carrier</p><p>3-who determines what the premium is for someone advantage policy/ The carrier with approval from CMS</p><p>4-what goes into determining that premium amount? Some of what the cost of doing business, the health and poplation and what Medicare deams as a fair amount.</p><p>5-who funds the dollars for paying medical bills/claims The money comes from Medicare which is from money you paid in during your working years and the Part B premium that the Medicare member pays in.</p></blockquote><p></p>
[QUOTE="Jim Simmers, post: 390449, member: 2674"] So fill in the blanks for me. 1-who does the medical industry send their invoices/claims to, the insurance carrier/ member may have cost share. Some like hospice for instance go to CMS. 2-who pays the actual claims sent by hospital. the insurance carrier 3-who determines what the premium is for someone advantage policy/ The carrier with approval from CMS 4-what goes into determining that premium amount? Some of what the cost of doing business, the health and poplation and what Medicare deams as a fair amount. 5-who funds the dollars for paying medical bills/claims The money comes from Medicare which is from money you paid in during your working years and the Part B premium that the Medicare member pays in. [/QUOTE]
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