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amkaloha
@amkaloha

Posts: 62
Joined: Sep 02, 2016

Medicare and Mayo

Posted by @amkaloha, Dec 28, 2016

Has anyone who has Original Medicare coverage had any experience with Mayo? I’d like to know what Medicare covers for a diagnostic visit. Will I be able to know if something is covered and how much it will cost if not covered? Any info of this type is appreciated. Thanks.

REPLY

Hi @amkaloha! I just spoke with a representative in Patient Account Services and he said yes, you will be able to know if something is covered and how much it will cost if not. He said we have many Medicare patients and didn’t say anything about coverage issues. Prior to your appointment, you’ll speak with someone in the Financial department via phone that can provide costs for services. Mayo Clinic is non-par with Medicare, meaning that we bill Medicare and then Medicare sends the payment to you, instead of directly to us. Here’s more info: http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/medicare.

@audreylaine

Hi @amkaloha! I just spoke with a representative in Patient Account Services and he said yes, you will be able to know if something is covered and how much it will cost if not. He said we have many Medicare patients and didn’t say anything about coverage issues. Prior to your appointment, you’ll speak with someone in the Financial department via phone that can provide costs for services. Mayo Clinic is non-par with Medicare, meaning that we bill Medicare and then Medicare sends the payment to you, instead of directly to us. Here’s more info: http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/medicare.

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Thanks so much for your quick response. Just a clarification: does this mean that I pay up front and then Medicare reimburses me? I have had problems when one of my doctor’s did not accept Medicare — I paid the doctor up front, they sent my claim to Medicare, then Medicare reimbursed me. The problem was that I have BCBS supplemental insurance (for the 20% Medicare doesn’t pay) and Medicare did not send BCBS my information and I could not get them to pay their part. I spent many hours on the phone with both of them, but to no avail.

@audreylaine

Hi @amkaloha! I just spoke with a representative in Patient Account Services and he said yes, you will be able to know if something is covered and how much it will cost if not. He said we have many Medicare patients and didn’t say anything about coverage issues. Prior to your appointment, you’ll speak with someone in the Financial department via phone that can provide costs for services. Mayo Clinic is non-par with Medicare, meaning that we bill Medicare and then Medicare sends the payment to you, instead of directly to us. Here’s more info: http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/medicare.

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@amkaloha I hate that you had trouble with this in the past. It is my understanding that this is the procedure followed, however, you will speak with someone from the Insurance Verification Office prior to your appointment. They will verify that information for both of your insurance providers is on file. Unfortunately, they cannot control the communication between Medicare and BCBS, but you you can ensure that both are billed. Additional Medicare info and resources can be found here: http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/medicare/more-on-medicare.

@audreylaine

Hi @amkaloha! I just spoke with a representative in Patient Account Services and he said yes, you will be able to know if something is covered and how much it will cost if not. He said we have many Medicare patients and didn’t say anything about coverage issues. Prior to your appointment, you’ll speak with someone in the Financial department via phone that can provide costs for services. Mayo Clinic is non-par with Medicare, meaning that we bill Medicare and then Medicare sends the payment to you, instead of directly to us. Here’s more info: http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/medicare.

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thanks so much. I know Mayo cannot control the communication between Medicare and BCBS. Thanks again.

In my experience some departments at Mayo will take Medicare patients and others do not. I have tried several times to get an appointment with a GI specialist who was recommended and have been denied an appointment. Also, I was unable to schedule an appointment with a Primary Care Physician. I was told they don’t take any more Medicare patients.

@audreylaine

Hi @amkaloha! I just spoke with a representative in Patient Account Services and he said yes, you will be able to know if something is covered and how much it will cost if not. He said we have many Medicare patients and didn’t say anything about coverage issues. Prior to your appointment, you’ll speak with someone in the Financial department via phone that can provide costs for services. Mayo Clinic is non-par with Medicare, meaning that we bill Medicare and then Medicare sends the payment to you, instead of directly to us. Here’s more info: http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/medicare.

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I had this problem with a provider and never did get reimbursed even though I followed all the instructions from Medicare.

@peck1944

In my experience some departments at Mayo will take Medicare patients and others do not. I have tried several times to get an appointment with a GI specialist who was recommended and have been denied an appointment. Also, I was unable to schedule an appointment with a Primary Care Physician. I was told they don’t take any more Medicare patients.

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Thanks Peck1944. It seems that we seniors on Medicare are made to jump through more hoops to get the care we need. And yet Medicare wastes so much money because of the incompetence within the system. Doctors don’t want to contend with them because they do not pay the exorbitant fees they charge. And so we seniors are actually discriminated against.

@audreylaine

Hi @amkaloha! I just spoke with a representative in Patient Account Services and he said yes, you will be able to know if something is covered and how much it will cost if not. He said we have many Medicare patients and didn’t say anything about coverage issues. Prior to your appointment, you’ll speak with someone in the Financial department via phone that can provide costs for services. Mayo Clinic is non-par with Medicare, meaning that we bill Medicare and then Medicare sends the payment to you, instead of directly to us. Here’s more info: http://www.mayoclinic.org/patient-visitor-guide/billing-insurance/insurance/accepted-insurance/medicare.

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Thanks again for your response. It’s hard contending with any system. Computers are programmed one way and no one can change anything that goes against that programming, especially any customer service person you get on the phone, even if you are in the right. So it is easier to relinquish the payment than to fight a loosing battle.

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