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Good visit with new doctor (!) - Glendale, CA

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Second star to the right ...
So, perhaps @Mary 's doctor is charging the fee for non-Medicare covered services, or she doesn't "accept assignment" from Medicare and is therefore able to change up to 15% more for Medicare-covered services.
Really articulate, concise, clear explanation of an incredibly convoluted system, Lynx ....


Thank you !!!!
 

lenora

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Not that it is on you, but I'm pretty sure that what the doctor is doing is illegal. As I understand it, when a doctor "accepts" Medicare they agree to accept as payment whatever Medicare allows...which is the reason why so many doctors no longer take Medicare, as they don't believe that the Medicare reimbursements are adequate. If it was as simple as the doctors just charging the patient a "surcharge", beyond what Medicare allows, there would be no reason that every doctor wouldn't do that, and continue seeing Medicare patients and charging them whatever they want, by way of a surcharge. They don't do that because I'm pretty sure that Medicare prohibits it. I'm not a lawyer, but you might want to take advantage of a free opinion from one of the legal services as to how it might impact you.
Hello Gerald, Mary & all other parties.....I just wanted to comment that you do learn something new every day. Still, plenty of doctors still take Medicare patients long after they've established decent practices paying good money. Perhaps they look at it as their part in doing the world some good....I don't know.

Mary, I guess you'd better find out the cost of the tests and whether or not this doctor practices Medicare the entire way. At least it's not the weekend and you have a few days to receive a reply. Also, if she doesn't take Medicare, then what is this going to cost you (approx. of course). Also, are you on Medicare or Medicaid? , I'm glad that you connected with this doctor and most sincerely hope things work out. One other though: Is it possible for a doctor to collect fees from Medicare for an office visit, yet charge separately for tests, etc. I know that Medicare doesn't pay for everything, after all, it has its codes. Yours, Lenora
 
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Mary

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@valentinelynx - thanks so much for all the info! :thumbsup:

All Medicare doctors (regardless of whether or not they accept assignment) can charge you for items and services that Medicare doesn’t cover.
I think this is their basis for the surcharge. Their website says:
In no event shall our “Holistic Surcharge Amenities” cover or pay for any medical services covered by Medicare.
I'm still going to call them to confirm, only I've been busy this morning, and have to rest . . . so I'll post more after calling them.
 

Mary

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Is it possible for a doctor to collect fees from Medicare for an office visit, yet charge separately for tests, etc. I know that Medicare doesn't pay for everything, after all, it has its codes
If a doctor orders tests that aren't covered by Medicare, the patient will have to pay out of pocket. So I always ask if a certain test is going to be covered or not, and if not, I have to decide before getting the test whether or not I want it. In general though I've found that most testing is covered by Medicare, at least that doctors have ordered for me. This is totally separate from Medicare paying for a doctor visit.
 

Sushi

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Even if it's a Skype call, wouldn't the Dr have to do basic disinfecting of the area and the computer he/she used for the call? I mean, unless it's a single-physician practice with no nurses. Otherwise, considering their possibility of multiple exposures during any given day, anyone in that office could pass it along to anyone else, including the patients.
My doc is calling from home using Facetime. Her office is entirely closed for now. She has all my records on her computer and I could see her checking my various test results while we spoke.
 

Mary

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Hi @Dakota15 - Here's Wikipedia on brain mapping: https://en.wikipedia.org/wiki/Brain_mapping

The only reason I did the brain mapping was because it was covered by Medicare. I was hoping it would give me some useful information re ME/CFS or sleep, etc. I did the brain mapping right before lock down started, so I had a phone appointment for the results. I didn't really learn anything, but also, I had been told no anitihistamines before the test. Well, I had to take an anti-histamine (I think unisom, can't remember) - otherwise I would not have slept enough to make the drive. I told the technician that I had to do this, and she said, no worries, do the brain mapping anyways, and they would use this as a base line.

What I'm leading up to is I don't know how reliable the results were because my brain was not at its best! due to the anti-histamine. There are deficits in memory (no surprise!) some other things I just can't remember right now :)whistle:), and then with lockdown and the distance I would have to drive, I just did not want to pursue neurofeedback, and also the fact that my results may not have been that accurate because of the unisom. I would like to see my results while undrugged! I was told I could do it again in 6 months time - Medicare would pay again - and I'm working on some new things for sleep (which I will post about if they pan out), so I might be able to do the mapping undrugged.

Having said all this, I did get hooked up with a doctor who I liked a lot. I spaced out calling their office last week about their billing practices but will call them this week.
 

lenora

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I forgot to post about this - I did call the doctor's office and asked about Medicare and the surcharge, and the simple answer was that there was no problem, as the surcharge was for services not covered by Medicare.
Thanks for letting us know. That was always my understanding. Yours, Lenora.
 

lenora

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Mary....I'm truly sorry that you're having such a rough go of it. When do you see the new doctor again?
Yours, Lenora.
 
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Mary

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Mary....I'm truly sorry that you're having such a rough go of it. When do you see the new doctor again?
Yours, Lenora.
Hi @lenora - I had a phone appointment I think 8 or 9 days ago, and am going to be getting blood work done soon. Actually I'm not really having a particularly rough time right now, I've had worse! :sluggish: I'm not expecting a lot from the doctor because I think I already have most of the bases covered that can be covered right now, but am curious to see if any of my numbers have improved, or not - I haven't had anyone knowledgeable for several years to work with, so we'll see!