Restriction to Collection of Payment from the Patient

The Code of Federal Regulations 42 CFR 424.555 states that if a provider’s billing privileges have been deactivated, denied or revoked, Medicare cannot make payment. The patient is not liable for payment of any charges. WPS Medicare will update the denial message to show the patient may not be charged. This message will also appear on the beneficiary’s Medicare Summary Notice. If a provider is not eligible for Medicare payment and has previously collected any amounts for services that could be payable by Medicare, these should be refunded to the patient as soon as possible.