Can Anybody Explain?

[bob47]

My wife is being monitored for cardio and circulatory issues and the doctor orders some tests approximately annually. Recently we were told by the doctor, and some friends have been told by their doctor, that medicare will only pay for one test on a particular day.

For example, if an echo cardiogram and a stress test, or an echo cardiogram and a carotid artery test are in order, they had to be scheduled on separate days.

I called the medicare help line and was told this is NOT TRUE. The representative said that if the tests were medically necessary and ordered by a doctor, medicare would pay their share for 2 or 5 or 20 in a single day.

Can anybody with experience in this industry explain why some doctors are saying otherwise?

[billethkid]

$$$$$$$$$$$$$$$$$$$$
btk

[n8xwb]

I suspect the tests are being done by your doctor. If you have to come back on separate days, I suspect he/she not only getd paid for the test but also for another visit. $ $ $

[NotGolfer]

I suspect the tests are being done by your doctor. If you have to come back on separate days, I suspect he/she not only getd paid for the test but also for another visit. $ $ $

YUP!!!! There are doctor's that do this to get more $$$$!!! THIS is why we plugged into the new medical practice being set up here in T.V. (USF)

[njbchbum]

My wife is being monitored for cardio and circulatory issues and the doctor orders some tests approximately annually. Recently we were told by the doctor, and some friends have been told by their doctor, that medicare will only pay for one test on a particular day.

For example, if an echo cardiogram and a stress test, or an echo cardiogram and a carotid artery test are in order, they had to be scheduled on separate days.

I called the medicare help line and was told this is NOT TRUE. The representative said that if the tests were medically necessary and ordered by a doctor, medicare would pay their share for 2 or 5 or 20 in a single day.

Can anybody with experience in this industry explain why some doctors are saying otherwise?

perhaps you could now call the doctor to let them know what you were told - and then ask if they want to confirm by calling the help line or should you ask the help line to contact them! would be fun to find out if all the tests could be scheduled the same day after that phone call to the doctor's office!

[jnieman]

I was having an ultrasound by my gyno dr. and had a similar experience. They wanted two visits and the two parts of the tests could clearly have been done all at one time. I called my insurance co. Blue Cross Blue Shield and she said the reason they do it is they get paid less if they combine the two procedures. Seems like an insurance rip off to me, but the insurance company is aware of it.

[SoccerCoach]

My wife is being monitored for cardio and circulatory issues and the doctor orders some tests approximately annually. Recently we were told by the doctor, and some friends have been told by their doctor, that medicare will only pay for one test on a particular day.

For example, if an echo cardiogram and a stress test, or an echo cardiogram and a carotid artery test are in order, they had to be scheduled on separate days.

I called the medicare help line and was told this is NOT TRUE. The representative said that if the tests were medically necessary and ordered by a doctor, medicare would pay their share for 2 or 5 or 20 in a single day.

Can anybody with experience in this industry explain why some doctors are saying otherwise?

I believe the cost of the test has nothing to do with it, but billing for another visit does.