We miss our Mayo Phoenix... Ever since Medicare kicked in

Posted by Paul @phoenixpal, Oct 20, 2022

We really do! We miss the professionalism, the focus on the patient, not feeling like we're using up the doctor's time....

But then 2 years ago I had a Total Knee Replacement and the billing nightmare began. Before turning 65, we never saw a bill. Aside from $20 copay, our Blue Cross policy took care of it all.

Then came Medicare and major surgery. It took 2 years 100s of phone calls between Blue Cross, Mayo billing and Medicare. And we still paid over $1000 out of pocket.

We want to come back to Mayo and will try a simple office visit.

My question is: Is there a service that will take the plethora of Medicare checks sent to us, random checks for $1.50 to $500, checks for who knows what part of the procedure and bill, a service that can work with Medicare, Mayo billing and secondary insurer to sort all the confusion? We would gladly pay for the service! However since all parties insist on only speaking to us, I'm not sure how it would work.

Our plan at the moment is to come back to Mayo for simple checkups, but go to another hospital/provider, that accepts Medicare payments for any major procedures.

Anyone have a solution for this problem?

Thanks
Paul

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Hi Paul, I have been to Mayo Phoenix several times and Medicare and my supplement has covered all the costs.

The Medicare ADVANTAGE program is NOT accepted by Mayo.

Their billing department may be able to provide you with the information you need.

Best wishes 🌵

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I am a patient of Mayo Rochester, and have traditional Medicare with a BCBS Medigap insurance. I self-referred to Mayo for lung surgery and later Cardiac stent. I am under CT scan observation. I have never seen a bill...it all gets paid by magic. I fear you do not have traditional Medicare but Medicare Advantage and have gone out of network. The advertising on TV is misleading, one loses choice of provider with Medicare Advantage. That is very important when one needs specialty treatment

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Now is the time of year that you can change your insurance plan under Medicare.

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Thanks for the feedback. We DO have traditional A&B Medicare. And we also have an outstanding BCBS policy where, as I said, before turning 65 we never saw a bill, just $20 copay.

@SusanEllen66 Possibly
because you've only had office visits and tests, not a major medical event like surgery requiring hospital stay?
@vic83 You're fortunate:-)
This problem is unique to Mayo Arizona, which although it "accepts" traditional Medicare, it does not accept PAYMENTS from Medicare. That's on you the patient.

A major medical event like my TKR has hundreds of line items (codes) each with its own cost, from for instance $1. 35 to $1,679.03. Try reconciling each of those Medicare checks you get in the mail, with what you owe Mayo and what BCBS should have picked up; leaving the patient still owing Mayo thousands.

As per my original post, I was hoping for tips from other Mayo 'zonies on how they dealt with this nightmare.

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@phoenixpal

Thanks for the feedback. We DO have traditional A&B Medicare. And we also have an outstanding BCBS policy where, as I said, before turning 65 we never saw a bill, just $20 copay.

@SusanEllen66 Possibly
because you've only had office visits and tests, not a major medical event like surgery requiring hospital stay?
@vic83 You're fortunate:-)
This problem is unique to Mayo Arizona, which although it "accepts" traditional Medicare, it does not accept PAYMENTS from Medicare. That's on you the patient.

A major medical event like my TKR has hundreds of line items (codes) each with its own cost, from for instance $1. 35 to $1,679.03. Try reconciling each of those Medicare checks you get in the mail, with what you owe Mayo and what BCBS should have picked up; leaving the patient still owing Mayo thousands.

As per my original post, I was hoping for tips from other Mayo 'zonies on how they dealt with this nightmare.

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@phoenixpal I'm with @vic83 in thinking you have a Medicare Advantage plan that Mayo Phoenix won't accept. I went to Phoenix for my Barrett Esophagus 7 months ago when my Rochester MD retired. I've been going to MN. for 5+ years. Phoenix accepted my BCBS medigap policy and I didn't owe a dime. In almost 6 years I've been billed once and paid for $8.00 by Mayo that they later refunded to me. I haven't received any bills from Mayo Phoenix nor have I received any money from BCBS. My balance owed Mayo for my visit back in March is $0.

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@phoenixpal

Thanks for the feedback. We DO have traditional A&B Medicare. And we also have an outstanding BCBS policy where, as I said, before turning 65 we never saw a bill, just $20 copay.

@SusanEllen66 Possibly
because you've only had office visits and tests, not a major medical event like surgery requiring hospital stay?
@vic83 You're fortunate:-)
This problem is unique to Mayo Arizona, which although it "accepts" traditional Medicare, it does not accept PAYMENTS from Medicare. That's on you the patient.

A major medical event like my TKR has hundreds of line items (codes) each with its own cost, from for instance $1. 35 to $1,679.03. Try reconciling each of those Medicare checks you get in the mail, with what you owe Mayo and what BCBS should have picked up; leaving the patient still owing Mayo thousands.

As per my original post, I was hoping for tips from other Mayo 'zonies on how they dealt with this nightmare.

Jump to this post

"This problem is unique to Mayo Arizona, which although it "accepts" traditional Medicare, it does not accept PAYMENTS from Medicare. That's on you the patient."
Yes, that would be a problem!
I have BCBS Senior Gold from Minnesota since 2009 which I took out originally because it allowed me to take it to another State and covered emergency travel. There are NO copays with this policy. I know Medicare made some plan type adjustments, but I got grandfathered in. I never see bills for anything, not visits, tests, hospital stays. It also includes eye refractory exam which I sometimes have to explain to the eye doctor staff since Medicare does not cover that. The only problem is when someone screws up.
Now when I was in the Mayo hospital last December, the person wheeling me out said that a patient told him that Mayo Arizona had stopped taking Medicare. And here in MN Mayo also stopped taking Advantage - because of plans without new contracts they said. So they said they were reserving for people with traditional Medicare.
And what about your visits to non-Mayo providers??? Do you submit and then get paid and then pay the doctor?
I understand the headache. The employer provided insurance I had in my last job required that 1) The doctor submits claim to the insurance company, 2) the doctor bills me 3) the insurance pays me, 4) I pay the doctor. I had to keep a spreadsheet tracking it all.
I am sure I am not allowed here to express what I thought of such a process! All these healthcare plans are not choice THEY ARE CONFUSION!

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@vic83

"This problem is unique to Mayo Arizona, which although it "accepts" traditional Medicare, it does not accept PAYMENTS from Medicare. That's on you the patient."
Yes, that would be a problem!
I have BCBS Senior Gold from Minnesota since 2009 which I took out originally because it allowed me to take it to another State and covered emergency travel. There are NO copays with this policy. I know Medicare made some plan type adjustments, but I got grandfathered in. I never see bills for anything, not visits, tests, hospital stays. It also includes eye refractory exam which I sometimes have to explain to the eye doctor staff since Medicare does not cover that. The only problem is when someone screws up.
Now when I was in the Mayo hospital last December, the person wheeling me out said that a patient told him that Mayo Arizona had stopped taking Medicare. And here in MN Mayo also stopped taking Advantage - because of plans without new contracts they said. So they said they were reserving for people with traditional Medicare.
And what about your visits to non-Mayo providers??? Do you submit and then get paid and then pay the doctor?
I understand the headache. The employer provided insurance I had in my last job required that 1) The doctor submits claim to the insurance company, 2) the doctor bills me 3) the insurance pays me, 4) I pay the doctor. I had to keep a spreadsheet tracking it all.
I am sure I am not allowed here to express what I thought of such a process! All these healthcare plans are not choice THEY ARE CONFUSION!

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@vic83. You wrote: "I am sure I am not allowed here to express what I thought of such a process! All these healthcare plans are not choice THEY ARE CONFUSION!"

When I began looking at Medicare I already knew I would go with Traditional Medicare as I did not want yet another insurance company demanding pre-authorizations or now allowing me to leave the local rural area for medical care. Still, it took many months of research to decide on which insurance company's Medigap plan I would choose (all the plans are the same, it's the cost and ease of working with the company that is different) and which Prescription Plan (Part D) I would choose.

I said many times that figuring this out is not for mere mortals like us. Confusion is right!!

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@naturegirl5

@vic83. You wrote: "I am sure I am not allowed here to express what I thought of such a process! All these healthcare plans are not choice THEY ARE CONFUSION!"

When I began looking at Medicare I already knew I would go with Traditional Medicare as I did not want yet another insurance company demanding pre-authorizations or now allowing me to leave the local rural area for medical care. Still, it took many months of research to decide on which insurance company's Medigap plan I would choose (all the plans are the same, it's the cost and ease of working with the company that is different) and which Prescription Plan (Part D) I would choose.

I said many times that figuring this out is not for mere mortals like us. Confusion is right!!

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You are so right. I don't want "choice of insurance carrier" I want coverage. These plans are screwy sometimes. It is necessary to research because there are some not well understood glitches. Like if you go originally with Advantage and then want to switch to Traditional, will you pay more for that Medigap policy later - that is because you are older. Medicare has defined these plans and assigned a letter to each type of Medigap plan to help one compare apples to apples 9not to confuse with Parts A, B, C, D).
Part D drug plans are the real devils. I ended up paying $800 more this year for drugs because I did not see the "small" print. That is the plan I chose had the Tier 1 and Tier 2 drugs subject to the deductible whereas other plans WITH CHEAPER PREMIUMS did not. I had not been taking many drugs so not too attentive and then I began to have medical issues and started taking more drugs. And somebody tell me why one plan says the retail price for a drug is $200 and another plan says the retail price is $35 for the same drug. So, if they charge you a specified % of retail price they still make you pay what they want.

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@phoenixpal

Thanks for the feedback. We DO have traditional A&B Medicare. And we also have an outstanding BCBS policy where, as I said, before turning 65 we never saw a bill, just $20 copay.

@SusanEllen66 Possibly
because you've only had office visits and tests, not a major medical event like surgery requiring hospital stay?
@vic83 You're fortunate:-)
This problem is unique to Mayo Arizona, which although it "accepts" traditional Medicare, it does not accept PAYMENTS from Medicare. That's on you the patient.

A major medical event like my TKR has hundreds of line items (codes) each with its own cost, from for instance $1. 35 to $1,679.03. Try reconciling each of those Medicare checks you get in the mail, with what you owe Mayo and what BCBS should have picked up; leaving the patient still owing Mayo thousands.

As per my original post, I was hoping for tips from other Mayo 'zonies on how they dealt with this nightmare.

Jump to this post

Oh, how horrible! Surgery is stressful enough and then to have to go through all that…
Yes, I have only had office consultation visits.

I’m sorry you have had to go through all of this nonsense. 🌵

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I googled and found this:
Does Mayo Clinic in Arizona accept Medicare insurance? "Mayo Clinic has chosen to be a nonparticipating facility in Arizona, and thus does not accept assignment from Medicare Part B for out-of-state residents at its campuses in Arizona. Nonparticipating means that Mayo Clinic does not accept the Medicare approved amount as payment in full." ............ Would that explain some of your issues? Are you a legal resident of Arizona?
Regarding your comments about only using Mayo for simple checkups and going elsewhere for major procedures. That is surprising to me. Mayo is a research institution and teaching hospital. It can be quite difficult to get an appointment. I am not clear on how Florida and Arizona Mayo Clinics compare to Mayo Rochester (the original Mayo). They were established later as satellites. My understanding is that the core of research/expertise is in Rochester. They do have some facilities/arrangements to treat the local population - it is 90 miles from the Twin Cities.

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