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<blockquote data-quote="DammitJanet" data-source="post: 572067" data-attributes="member: 1514"><p>Medicare rates arent that much higher. I get my EOB's in the mail about every 2 or 3 months and the providers are lucky to get a fifth of what they are billing the insurance companies. Now I realize that they are most likely billing the insurance companies a higher rate simply to attempt to get something close to what they want but if I didnt have Medicaid for them to bill as a secondary provider, I would be stuck for the non-covered parts. And I have asked the receptionists what the amount is for a cash patient to see them and it is darn near what they bill the insurance company for...less a 20% discount if you pay in cash upfront. Now granted this is the pain clinic. I abhor them because I have caught them double billing for UA testing for drug screenings more than once. I have also found out why they pulled me from doing the "procedure on my knee". Medicare wont cover it. LOL. Ahhh shucks. The one I was willing to do isnt covered. Funny thing is if they recommend doing it at their clinic, they have to eat the cost of it so they have now backtracked and are saying it wouldnt do me any good! </p><p></p><p>I am thinking of calling Medicare/Medicaid and reporting this and recommending they start demanding more stringent policies where they need prior authorization for all procedures done at pain management centers from doctors not affiliated with these centers. These procedures are just money makers for them.</p></blockquote><p></p>
[QUOTE="DammitJanet, post: 572067, member: 1514"] Medicare rates arent that much higher. I get my EOB's in the mail about every 2 or 3 months and the providers are lucky to get a fifth of what they are billing the insurance companies. Now I realize that they are most likely billing the insurance companies a higher rate simply to attempt to get something close to what they want but if I didnt have Medicaid for them to bill as a secondary provider, I would be stuck for the non-covered parts. And I have asked the receptionists what the amount is for a cash patient to see them and it is darn near what they bill the insurance company for...less a 20% discount if you pay in cash upfront. Now granted this is the pain clinic. I abhor them because I have caught them double billing for UA testing for drug screenings more than once. I have also found out why they pulled me from doing the "procedure on my knee". Medicare wont cover it. LOL. Ahhh shucks. The one I was willing to do isnt covered. Funny thing is if they recommend doing it at their clinic, they have to eat the cost of it so they have now backtracked and are saying it wouldnt do me any good! I am thinking of calling Medicare/Medicaid and reporting this and recommending they start demanding more stringent policies where they need prior authorization for all procedures done at pain management centers from doctors not affiliated with these centers. These procedures are just money makers for them. [/QUOTE]
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