Medicare has certain rules and regulations in place to prevent fraud, waste, and abuse. One that is occasionally overlooked is the rule that a provider must treat patients for at least eight minutes (hence 8-minute rule) to receive Medicare reimbursement.
With this rule, patients can be assured that doctors aren’t simply rushing through to get to the next patient and that their Medicare is paying for quality service. The rule is a great way to reassure your clients that they will be cared for with Medicare.
While eight minutes doesn’t seem like a long amount of time, think about how you usually spend your time in a doctor’s office. Most of it is probably spent in the waiting room – then you’re whisked away to a room where you sit and wait by yourself for ten minutes, then a nurse comes in and checks your vitals, then it’s another ten minutes of waiting before the doctor can come in and tell you you have a cold.
If a doctor actually spends eight minutes with you, they can truly observe everything – your weight, your skin, your symptoms if you have any – not just what you ask him to look at.
Seniors tend to spend more time in doctor’s offices as they tend to have more concerns. More often than not, a senior is sitting in a patient room for much longer than eight minutes – but, some treatments, like physical therapy, may only take a few minutes to perform. If a doctor spends ten minutes observing and speaking with the patient and then only three minutes performing physical therapy, Medicare will not pay for the physical therapy treatment.
As an insurance agent, it’s not your job to track the eight-minute rule – that’s up to the providers. All you can do is assure your clients that their doctors have to comply with the eight-minute rule.