Seniors with Medicare, is Mayo worth the hassle?

Posted by Paul @phoenixpal, Mar 7, 2020

If your answer is "yes", please share: How do you do it ?!?

We have been with Mayo for almost 4 years. It has been wonderful service.
I've also had a great BCBS PPO that was practically seamless. I never saw a bill, just an occasional $20 copay.

And then, I turned 65, went on Medicare, and the billing nightmares began. Without a chronic illness, it has taken 18 months for me to realize how difficult this is going to be from now on. In April my wife turns 65, so the billing/paperwork dysfunction will double.

Example: Last October my Mayo primary care prescribed a colon cancer screening colonoscopy. It had been 10 years since my last (paid for 100% by BCBS). While there, they found 2 polyps worthy of biopsy. (They were negative.) Mayo filed with Medicare first, as my primary insurance. It turns out that the two procedure codes conflict: one a screening test, the other a diagnostic procedure (the polyp biopsy). Because of the code conflict, Medicare will only pay for one of the two parts. I now have to appeal to Medicare by re-submitting all of Mayo's medical notes myself. Whatever Medicare declines to pay, the secondary (my BCBS) automatically declines to pay as well.

Now, two weeks ago I had a $48,000 TKR. I am sure that the surgery was first rate, world class at Mayo. But, I am now watching the billing itemization role in to Medicare. There was, for example, a $3 blood draw charge, an $18.30 EKG for which Medicare has now sent me a $2.98 check to pay Mayo etc etc ... up to $48K

Sure, Mayo has a great reputation. But as a patient having to deal with these Byzantine medical billing and coding issues, and having to manually pay Mayo with the checks that Medicare sends me, is it worth the time and headaches? I am sure that in a big city like Phoenix, there are plenty of good, qualified doctors who work with Medicare. Why would we stay with Mayo?

I see a lot of seniors over at Mayo. How are they dealing with this ?!?

Interested in more discussions like this? Go to the Visiting Mayo Clinic Support Group.

collenp | @collenp | Apr 13, 2023

MAYO CLINIC IS ABSOLUTELY WORTH GETTING AN APPOINTMENT.
In 2019 I received a diagnosis of Tonsiliary Cancer by an ENT physician in New Jersey. Their office draged their feet for 2 weeks trying to get a Cat Scan pre cert with my private insurance Blu Cross Blue Shield. Not yet on Medicare. Well to make a long story short. I advocated for myself, wrote a cover letter, faxed almost 30 pages of medical records, and 3 days later I received a phone call from Mayo Clinic in Rochester Minnesota.
I contacted Mayo's concierge service, they scheduled my flights and booked my hotel right across the street from the hospital. They provided shuttle pick up service. I was seen by Dr. Eric Moore and his team.
I DID NOT have tonsiliary cancer. I was there for 2 weeks, as an outpatient, scheduling my appointments with a specialist each day as a checker. I have some minor health problems but no cancer. Don't hesitate to go to Mayo. It was the Best medical decision I ever made. Good Luck to everyone in your search for proper and correct diagnosis and medical treatment. Take care
God Bless!