GHP Pays Charges in Full

40.4.1 - GHP Pays Charges in Full (Rev. 11550; Issued: 08-12-22; Effective: 10-13-22; Implementation:10-13-22) If the GHP pays the provider's, physician's, or supplier's charges in full, and the provider, physician, or supplier is obligated to accept, or the provider, physician, supplier voluntarily accepts, consider the GHP's payment amount as full payment. The A/B MAC and the DME MAC makes no Medicare payment. (Physicians and other suppliers that participate in BlueShield plans or HMO/PPO arrangements typically must accept the Blue Shield plan’s or HMO/PPO arrangement’s approved amount as payment in full.) Any excess of the GHP’s payment over the gross amount payable by Medicare is not subtracted from the provider’s Medicare reimbursement. The provider submits a “no payment bill” in accordance with Chapter 3 – MSP Provider Billing Requirements, §40.1.