July 7, 2009 - 1:14pm
I am new here and may have overlooked this subject. My husband goes to a pain clinic for his Hydrocone meds. He was going every three months, now every month. He has a urine test each time he goes.
Last month, he was not seen because he had had a Workmen's Comp claim back in 1973. They refused to see him until they got his records. WC destroys the records after 20 years. So after many calls, I finally got a woman at WC who faxed them a letter stating there were no records, and why, which the Dr's office already knew. But according to Medicare this all had to be done. He had to wait another 2 weeks to get back in for his appt.
Now the clinic says "medicare is getting picky and doesn't want to pay for certain things" one of which is the urine/blood test he has to do each time he goes in. He would have to pay $241 for this test. However, when he goes in...they will discuss with him at the desk, "options" they have to try to help.
Does anyone here know anything about this, or what steps we can take to find out if it is actually Medicare's doing? I have searched thru their site and can't find anything new about this (or old for that matter) but how can they just change something at the drop of a hat causing unexpected expense and hardship to people on Medicare? He has straight Medicare/Medicaid and a prescription plan.
Any comments will be sincerely appreciated. (as a note he has degenerative arthritis of the spine and also in the "neck" spine where one disc has disintigrated and when he moves his head to either side, particles are pushed out into his neck impairing side to side movement)
July 8, 2009 - 4:36pm
#2
a 14 panel urine screen
costs $42, an its up to the Dr. if the screen is ordered or not Woodstock
July 8, 2009 - 10:14pm
#3
I'm sure the cost of the test
I'm sure the cost of the test varies depending on where you live, what exact test is ordered and what company does the test(I'm sure the MD's office prob. adds some administrative fees somewhere in there too j/k LOL).
Anyhoo, is your hubby seeing a rhuemetologist? If not, he needs to get into one ASAP!!! There are several different arthritis forms that specifically attack the spine. They all vare similar, yet quite different at the same time. He would benifit greatly by seeing this specialist if he is not already. There are great new & fairly new medications available for these conditions that are changing lives. ALSO, I have several forms of arthritis, spondylarothrapy being one of them and my Rhuemy perscribes all of my pain meds also meaning.... NO pain mgmt., NO drug screens, specific specialty care, I don't have medicare, Am eligable, but use my hubby's ins. instead. I do know that medicare covers even the most expensive of the newer treatments, remicade, but not some of the blood tests that are used to diagnose certain conditions. Makes no sense, but my point is, Medicare covers rhuemetologists, they specialize in treating your husbands condition, I have never, ever, in 10+ years of seeing them, had one order a urine test even though they have been writing my CII pain medicine perscriptions. This would be my advice, find a rhuemetologist! Sorry for rambling and spelling errors, one of those nights. Good Luck!
I have medicaid and so far every U/A has been paid by them. I get a UA every month and have been for at least a yr and 1/2 now. Every patient at my pm has to have a UA if your getting meds, which basically means every month b/c they don't write more than a 30 day supply. Which I understand and don't mind for the most part but after being there for 1-2 hrs than it's a pain. (I know off subject) I just had to sign a new form about this though stating that if my insurance won't cover the cost then I would have to pick it up. When I asked billing about this, I already owe him enough $ due to previous insurance, they said that Medicaid was paying for at this time. But since they do this every time and not all insurances do pay for them that's why the new contracts came out.
Have you called Medicaid about this? I've only been on this insurance for a short time and I've had several problems with it. I've had to pay for Rx that I know I shouldn't have and had to call that in to submit a claim. Also, I've had billing issues with this insurance as well. On both ends from a doc's office and while filling myself. Unless every step is properly followed the hospital or office will not receive their payment. And I have seen this passed on to the patient. Maybe the office could get it preathurized? Like a rx or a procedure?