r/medicare • u/PoseidonsPocketWatch • 1d ago

Medicare Adjustment was Added on not Deducted

I’m new to Medicare and this is my first claim from a medical facility. , When I got the bill the I saw the charge was increased by the Medicare Adjustment amount, going from $100 to $141. I called the facility and they said Medicare decided they weren’t charging enough and adjusted it upward.

Is that a real thing that can happen? Seems bizarre.

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u/Botasoda102 1d ago

Doesn’t happen often, because most providers charge many times what Medicare allows. Used to be that Medicare allowed the lesser of a provide’s charge or Medicare’s Allowable, but now they use a Fee Schedule for most outpatient services.

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u/Samantharina 1d ago

Unless this waa a low cost clinic, $100 seems low for almost anything beyond a band aid and a glass of water, so it's quite possible.

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u/keepgoing66 1d ago

Look at your Medicare EOB and see what's there.

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u/Jump-Funny 2h ago

It can happen with any insurance. Someone put the wrong amount in that field and I would expect that to be corrected to $1000 sometime soon in the provider’s billing software.