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Politics : A US National Health Care System? -- Ignore unavailable to you. Want to Upgrade?

To: Lane3 who wrote (34873)	3/5/2014 11:45:20 AM
From: i-node	1 Recommendation Recommended By Ben Smith Respond to of 42652

>> No one at CMS/Medicare was interested. I had this happen with my mom (> 10 years ago). During her cancer treatment she received an EOB after a lengthy hospital stay; even in her mid 80s she, as a former nurse, had some awareness of what was and wasn't done. She assured me "I never got that..." I dutifully called Medicare to advise them of the billing problem, and it was an exercise in frustration. At the end of the day, I told mom, "I tried, and nobody cares." I'm guessing this problem isn't that unusual among people who do know what's going on. But even people who are familiar with the processes don't know what constitutes a level 4 visit vs. a level 2. They may know they did or didn't see the doctor, but are clueless about what he ordered. I went for my physical recently, and when they called with my labwork they had done a test for testosterone as part of the routine labs. This is a test I absolutely would not have had, had I known he was ordering it -- if for no other reason, I'm not about to take any of these "low-T" drugs out there given the side effects. But he ordered the test and checked the box, and I got the test. A visit that used to be a 99213 is now a 99214, because he checked all the boxes necessary to "document" it.

To: Lane3 who wrote (34873)	3/5/2014 11:45:38 AM
From: Murrey Walker	1 Recommendation Recommended By Brumar89 Read Replies (1) \| Respond to of 42652

When I was first in Medicare I read the CMS reports. Found that Medicare was billed for "multiple genital warts" when what was removed was one wart on my finger. I tried to report it without success. No one at CMS/Medicare was interested. I know (at least from our conversations, I think you do) you fiercely defend the "system" in DC. But, the above quote is indicative of what we, as a country run into with the "gubment". You get an answer from someone, who's job capability spans the spectrum; good, bad, or indifferent is, more often than not, the result. After all these folks are salaried, 9 to 5 types who put in their time, and patiently wait their retirement. Not only is no one at CMSMedicare interested, but your chances are slim to none that you'll find that interested "needle in the gubment's haystack", who will give you what you're actually looking for.

To: Lane3 who wrote (34873)	3/5/2014 3:00:43 PM
From: J_F_Shepard	Read Replies (3) \| Respond to of 42652

When I was first in Medicare I read the CMS reports. Found that Medicare was billed for "multiple genital warts" when what was removed was one wart on my finger. I tried to report it without success. No one at CMS/Medicare was interested. Did you complain to the provider's office?? That's happened to me a couple of times and also from a dental provider..... In all cases the billing office reduced the charges either to Medicare or my dental insurance or me...... I hate when they pull that crap and being associated with Medicare has nothing to do with it.....simple greed and fraud.... I posted here a few months ago about an orthopedist from my group who had billings of over 7 million dollars over two years.... He billed for fake surgeries, phantom surgeries......as many as 19 surgeries a day... He claimed office visits from about 50 patients a day..... He was caught but it wasn't by his own billing department.... The group settled a law suit for about 4 million......others are pending and he is awaiting trial... You should know what services you received and the patient shouldn't have to know the codes to see what he was billed for ....