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.

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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@mpflood7 I can offer information about how my testing at Mayo has worked. Every time after my appointment is scheduled I receive the time and location of lab work that is done first thing that morning. When something else was ordered by the doctor the person doing scheduling worked to make it all happen same day. On some occasions during my appointment the doctor recommended other tests. Sometimes it was possible that could happen same day, and if necessary scheduled the next day. There has always been consideration for our travel plans. I hope this assures you that even though the system is huge, priority of patient care has always been our experience. For 18 years.
Peace, Nancy

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@mpflood7, were you able to call Mayo Clinic in Florida and ask if they were contracted with BCBS Blue Card PPO. According to the site and the PDF that Mayo provides, Florida is contracted.
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/contracted-health-plans
You may also contact Mayo Clinic directly at 904-953-2272, 904-953-7058, 844-217-9491 (toll free)

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@amandaburnett

@mpflood7, were you able to call Mayo Clinic in Florida and ask if they were contracted with BCBS Blue Card PPO. According to the site and the PDF that Mayo provides, Florida is contracted.
https://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/contracted-health-plans
You may also contact Mayo Clinic directly at 904-953-2272, 904-953-7058, 844-217-9491 (toll free)

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Thank you Amanda. On top of even if I will get admitted for the Collaborative care I am now told today is only afforded by Internal Medicine at Mayo (not other medical departments), this is all very confusing. I can’t get a direct answer on insurance from anyone. My understanding is that my Florida BCBS Blue Select Gold PPO (1535 Plan) only becomes a Blue Card when I am out of state. While in state (Florida), I am told Mayo Clinic (Jacksonville) does not accept my Blue Select plan. I am going to continue to follow-up but any further insights are welcome. I’d also like to see it (especially insurance/billing) in writing. Thanks.

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