Does Mayo Not only Test/Diagnose but also Treat - Out of State Patient

Posted by mpflood7 @mpflood7, Oct 3, 2020

Does Mayo Not only Test/Diagnose but also Treat - Out of State Patient? I need Test/Diagnose but also Treatment. Am wondering since I am visiting from out of state and my understanding is that all is out-patient. Can someone clarify? Thank you.

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While I don't know much of the quality of care at the Mayo Clinic (though 2 neurologists at Harvard have also independently recommended Mayo), I have also checked into Columbia Presbyterian and Johns Hopkins. From what research I have done, I am definitely leaning toward Mayo Clinic. Administratively at least, Mayo is far better than either of the other two. For example, I haven't even found such a resource as this wonderful, "Connect" at the other two. So if I divide the hospital "experience" into 2 parts - 1) administrative; and 2) care quality; Mayo certainly wins for the administrative. I guess I'll leave much of the ultimate call regarding care quality to my local doctor. Thank you again.

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@colleenyoung

@mpflood7, I'm so glad that @bernese53 asked for further clarification. You may also be interested in the information provided in this discussion:
- Advice for financing visits to Mayo Clinic in Rochester https://connect.mayoclinic.org/discussion/advice-for-financing-visits-to-mayo-clinic-in-rochester/

You ask very prudent questions about ongoing care and cost. I highly recommend that you call Mayo Clinic appointments with these questions. They will work with you to understand the full extent of costs, insurance and inpatient vs out patients services. http://mayocl.in/1mtmR63

Mayo also has a cost estimator, but I think you may not yet have enough information about your diagnosis and treatment plan for it to be useful. Here is the link if you'd like to check it out. https://costestimator.mayoclinic.org/

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Thanks. That reminds me - do they send you an appointment and testing itinerary before you go to Mayo? Do they base it on your medical records (and amend as they find more while you are a patient)? I'm going to look at the sites now - especially the inpatient vs. outpatient.

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Yes, they do. It is also beneficial to create an online patient portal. What are you hoping in the inpatient vs outpatient sites?

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@colleenyoung

@mpflood7, I'm so glad that @bernese53 asked for further clarification. You may also be interested in the information provided in this discussion:
- Advice for financing visits to Mayo Clinic in Rochester https://connect.mayoclinic.org/discussion/advice-for-financing-visits-to-mayo-clinic-in-rochester/

You ask very prudent questions about ongoing care and cost. I highly recommend that you call Mayo Clinic appointments with these questions. They will work with you to understand the full extent of costs, insurance and inpatient vs out patients services. http://mayocl.in/1mtmR63

Mayo also has a cost estimator, but I think you may not yet have enough information about your diagnosis and treatment plan for it to be useful. Here is the link if you'd like to check it out. https://costestimator.mayoclinic.org/

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Colleen - I'm stunned. I used the Cost Estimator - for an Office Visit for a New Patient (CPT: 99204). It says that my health insurance only covers $12 of $462, leaving me with $450. My Explanation of Benefits states that at most, for a Specialist appointment, I just pay $60 (which I was expecting). That is how it works currently with my Specialists in Florida, and how I was told it would work in MN.

If you know, please tell me I am wrong - as this would possibly prevent me from going to Mayo Clinic at all. I have Blue Card PPO (which I am told is accepted at Mayo Clinic, Rochester - even though it is not accepted at Mayo Clinic Florida where I live). Please, again, let me know. Thanks.

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In my experience the Cost Estimator is just that....an Estimator. For me, it was not always accurate.

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@mpflood7

Colleen - I'm stunned. I used the Cost Estimator - for an Office Visit for a New Patient (CPT: 99204). It says that my health insurance only covers $12 of $462, leaving me with $450. My Explanation of Benefits states that at most, for a Specialist appointment, I just pay $60 (which I was expecting). That is how it works currently with my Specialists in Florida, and how I was told it would work in MN.

If you know, please tell me I am wrong - as this would possibly prevent me from going to Mayo Clinic at all. I have Blue Card PPO (which I am told is accepted at Mayo Clinic, Rochester - even though it is not accepted at Mayo Clinic Florida where I live). Please, again, let me know. Thanks.

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@mpflood7, again, I with @bernese53. In patient time is kept to a minimum for treatment and one is not usually an inpatient during testing and diagnostic phase.

As mentioned, there are too many variables for the cost estimate to be accurate at this point. However, it has exposed some questions you should definitely ask when you contact Mayo Clinic to avoid cost surprises.

You also asked about test itinerary. Other members can share their experiences. Generally the first tests appointments are scheduled. However, should the initial tests indicate a different course of investigation, Mayo will schedule and reschedule appointments and accommodate your time at the clinic to maximize the best use of your time during your time there.

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@mpflood7

Colleen - I'm stunned. I used the Cost Estimator - for an Office Visit for a New Patient (CPT: 99204). It says that my health insurance only covers $12 of $462, leaving me with $450. My Explanation of Benefits states that at most, for a Specialist appointment, I just pay $60 (which I was expecting). That is how it works currently with my Specialists in Florida, and how I was told it would work in MN.

If you know, please tell me I am wrong - as this would possibly prevent me from going to Mayo Clinic at all. I have Blue Card PPO (which I am told is accepted at Mayo Clinic, Rochester - even though it is not accepted at Mayo Clinic Florida where I live). Please, again, let me know. Thanks.

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Everyone's situation is different, I would strongly suggest you make two phone calls to verify coverage and cost. Not every Blue Cross plan is the same, and may have different in / out network contracts.

1. Call the phone number on back of your insurance card and verify Mayo Rochester is considered in network.
Your insurance company may ask for following information, the Tax ID is different for Mayo in other states.
Mayo Clinic's campus in Minnesota
Mayo Clinic: Tax ID No. 41-6011702
Mayo Clinic Hospital: Tax ID No. 41-0944601

Reference: https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/faq

2. Call Mayo Mayo Clinic directly at 844-217-9591 with your policy info and ask specific questions about coverage at Mayo Rochester.
Do not be surprised if on hold for awhile before getting connected. They are very busy.

Time spent prior to arrival on coverage will prevent surprises when arrive.

Laurie Miller

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Thank you. I sure hope so.

I noticed in my plan that no "balance billing" is allowed (ie, balance remaining owed by patient) ... but will have to look further.

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@roch

Everyone's situation is different, I would strongly suggest you make two phone calls to verify coverage and cost. Not every Blue Cross plan is the same, and may have different in / out network contracts.

1. Call the phone number on back of your insurance card and verify Mayo Rochester is considered in network.
Your insurance company may ask for following information, the Tax ID is different for Mayo in other states.
Mayo Clinic's campus in Minnesota
Mayo Clinic: Tax ID No. 41-6011702
Mayo Clinic Hospital: Tax ID No. 41-0944601

Reference: https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/faq

2. Call Mayo Mayo Clinic directly at 844-217-9591 with your policy info and ask specific questions about coverage at Mayo Rochester.
Do not be surprised if on hold for awhile before getting connected. They are very busy.

Time spent prior to arrival on coverage will prevent surprises when arrive.

Laurie Miller

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Thank you Laurie. Any chance anyone (eg, Mayo) will put anything in writing regarding billing - beforehand?

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@mpflood7

Thank you Laurie. Any chance anyone (eg, Mayo) will put anything in writing regarding billing - beforehand?

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Mayo has contracts with your insurer in terms of “balance billing” and so forth. Since you plan to go to Mayo for diagnostic testing and treatment, Mayo may not be able to specify anything in terms of billing.

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