Cost estimates before 2nd insurance is even billed?

@dwwaggoner
I do not work for Mayo, but I can talk about my experience with estimates and billing. I am on original Medicare (A&B) with a supplemental (G) policy.

When Mayo schedules tests, referrals, procedures, they do an estimate to verify that it is covered by my Medicare insurance. This is based on the ICD-10 code used to order. If it is not covered, I am asked to sign an ABN (Medicare Advance Beneficiary Notice) acknowledging that if Medicare does not pay, I will be responsible.

If Medicare approves, then my supplements will also be covered.

Once you have tests or procedures, then it is submitted to Medicare to pay their portion, and the supplemental pays the remaining.

I hope my understanding of the process helps, but you can always call 1-844-217-9591 to speak with a Patient Account Services representative with questions about your bill, financial responsibility, cost of services, and insurance.

@roch It's not the same as you, it's the 20% of the test not already paid by Medicare, that was approved. It's the 20% that my Medigap policy is contracted to pay. It ends up with a zero balance. Apparently Mayo's billing is not seeing the unpaid insurance amount BEFORE it drops the payment due. I already did the math and if Medicare paid, and charges were not declined, I will owe zero balance. Medigap policies only pay when Medicare has approved the charge according to the ICD code. Mayo accepts Medicare payment, and Medigap payments, they just always bill before they get the secondary payment.

@dwwaggoner
Very odd that they would charge you before both policies are processed. I never get a bill until both are processed. Actually, after the deductible is met, I never get a bill. If I look at my billing details, it shows insurance processing.

I strongly recommend calling Patient Account Services at 1-844-217-9591 to verify that they have the correct information about your supplemental on file.

Your charges are being handled differently from mine, and it sounds like we have the same type of coverage.