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Help with understanding test results
Autoimmune Diseases | Last Active: Jun 29 6:13pm | Replies (79)Comment receiving replies
We all have the right to challenge questionable bills but particularly for people who don’t have graduate degrees in forensic accounting and who aren’t billing specialists, it’s far from easy.
I am a former Medicare fraud investigator. Medicare is confusing to many and when people are signing up at times they are dealing with aggressive sales people.
“Advantage plans” (the ones that come with vision, dental plans and free rides to doctors offices—-are forms of managed care that the government contracts out to private companies. Those companies have an incentive to manage medical expensive to maximize revenue of the corporation. “Original Medicare” like you and i have, tends to be considerably more expensive and is intended to provide us as policyholders with much more control in self referral and in getting multiple second opinion.
What you mentioned re getting billed for asking a simple question appears to represent a relatively new “policy/protocol@ that i first saw emerge about 18 months to 2 years ago. What i saw was a number of major medical facilities starting posting on my chart that they reserved the right to bill patients for asking questions. The criteria for doing so, is highly ambiguous and acceptable medical coding and billing can’t represent an outright lie.
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@elisabeth007 @becsbuddy Your post is very interesting, thanks. It appears to be one major medical system, University of Md, that "rubs me the wrong way". In addition to questionable Medicare charges, I am now encountering a new problem with them while trying to find a Rheumy for the first time, for the first auto immune test I've ever had. This particular medical "system" does not want me to fill out any patient questionnaires or history of any sort, before seeing one of their Rheumys. They insist they already have my info in their computers, (from my seeing a very few other docs over the years, for unrelated complaints). Since the docs I see most are in another medical system, and not "connected" to My Chart- the info available in My Chart is incomplete (at best). Further, some of my symptoms started 50 years ago (before computers) and other symptoms seemed not "noteworthy" even until I got the auto immune test results recently. I hibernate in the summer months and am greatly slowed-the idea of having to speed read and explain my list of symptoms, without a formal questionnaire is daunting. (Possible solution: fill out one of the downloadable indepth questionnaires provided on-line by rheumatologists at other medical centers and submit that well before my appoint time.?)
The U of Md "appoint. makers" also insist that I am not a "new patient" since I am already in their "system" (computer), from seeing just a few of their docs over the years, (for totally unrelated complaints). An earlier attempt resulted in the office wanting me to fill out forms in their office, before my appointment, for a 30 min appoint slot. I feared that may very well have left me with 15 mins face time with their specialist, in addition to half-filled patient history, and I cancelled.
Just yesterday I found a Rheumy, also at U of Md, that takes new patients and made an appointment. It was only later that it sunk in that there was (again) no patient history needed. when asked. When I checked My Chart the appoint was listed as "new Patient"-but I've no real idea how long that actually is. I guess I could call Monday to find out, except there is the no (complete and accurate) patient history to contend with again. It was only then that I realized it is this one particular medical center outfit that "triggers" me, because of their "office practices".
I feel a round hole trying to fit into their square slot "office practices". Because my symptoms have been accumulating over 50 years, it feels ludicrous to believe I can be "heard" and Dx'ed (based on out of date, incomplete patient info) and have my questions answered-in 15-30 mins time. I did not experience these same constraints with another nearby medical "system" but their rheumys are not taking new patients at this time. Fortunately, I am not in dire need and believe I need to be seen there-in order to avoid these exhausting mazes. Not sure if this is "drive-thru, fast food" medicine being practiced at U of MD but it hurts my soul, and I feel for the demands being put on their docs.
My hubby has the lesser cost "HMO like" Medicare supplement. I am beginning to wonder what the benefit of my expensive supplement plan is, if I have to wait months to see a specialist for a "real" visit.