Denial of mayo visit

nancyeburford, there was some speculation here on connect that Medicare Advantage might be a prohibiting factor, so maybe insurance. I do wish Mayo would indicate a reason for denial of service. I've heard of patients being denied because the specialists were overscheduled.
There are other excellent medical care facilities, don't delay treatment.

Thank you so much. I guess it would be nice if they were upfront. I was under the understanding. Rochester took Medicare Advantage. They let me set up a royal and fill out a questionnaire with ability to be very thorough. Know many people from our town that were not denied and haven’t had all the tests and specialists I have gone through

@nancyeburford Here is the page for insurance information for Mayo that I'm posting for everyone who is wondering. The best bet is to call the Mayo Insurance & Billing office and ask if your insurance is accepted before requesting an appointment. Medicare "Advantage' plans tend to look at claims that were already paid and re-evaluate them. They may deny them after the fact, and then come back to the provider for reimbursement. That's why a lot of providers won't accept them. If a provider is in the network of the "advantage" plan, it is a bit like being an HMO provider and they dictate what the provider is able to charge for the care often at a lesser rate. I can understand why Mayo doesn't accept them because it is a risk that they will loose money if claims are reassessed and denied. This is the reason I stayed with real Medicare because that is accepted at Mayo and elsewhere in the country.
https://www.mayoclinic.org/billing-insurance/insurance

Jennifer, Nancy felt like Mayo wouldn't tell her the real reason for denial. Maybe the person she spoke with didn't know? Denial after the care and even after payment. That is really interesting. Thanks.

I need to clarify. I have had many tests in my home town with no diagnosis or appropriate treatment. Thank you all for your input

@nancyeburford
What symptoms do you have and what specialists and tests have you seen/had so far?

Neurology neurosurgery rheumatology functional medicine general practitioner mri pelvic and cervical bone scan lots of blood work. Burning of extremities muscle cramping all intermittent pain in feet all intermittent. No balance or weakness issues

@nancyeburford I'm sorry to hear that your referral from your GP for Mayo consultation was denied. I can't offer you any insights into why that happened but I can provide you with a few suggestions going forward.

1. Is there a medical center that is part of the Mayo Clinic Care Network where you could be seen? These medical clinics have an arrangement with Mayo where their medical providers consult directly with Mayo medical providers.

Mayo Clinic Network Members:

-- https://www.mayoclinic.org/about-mayo-clinic/care-network/network-members

2. Would you be willing to talk with your GP about this denial and ask that they contact Mayo Clinic for more information? Your medical provider may be able to access information that was not readily available to you.

Are these suggestions helpful to you?

Thank you. None in Colorado. Yes I will talk to the functional medicine doctor tomorrow.

@nancyeburford
Did you have EMG nerve conduction studies and skin biopsy to test for small fiber neuropathy done by your neurologist? Did your bloodwork show any deficiencies or toxicity? Have you been tested for glucose levels and A1C to rule out pre-diabetes or diabetes? Do you drink alcohol or smoke cigarettes? If so, it would be good to stop as it affects your nervous system.

Have you read and reviewed all MRI reports and blood work results? I always review everything in detail to see if anything is abnormal and help me ask questions and do further research.

Do you notice anything that triggered your intermittent symptoms?