Telephonic checks and Medicare?

I was due last Thursday for my first official telephonic check at 9:40. I had my little modem all ready and was awaiting the phone call. Instead I got a call from the tech who said due to Medicare rules I couldn't have a check until January (?) because last month on Oct 17th when I had a "spell" and fainted they had done an inquiry in the office.

I said where is that written and she couldn't answer. Is there a time frame or something? I read here that people have such good rapport with their reps and cards. Is it specific to US Medicare? I guess I could self pay (how much does it cost?) I have had no problems since the visit last month. It has never activated as of that date.

At that time the tech said she did some "tweaking." Different tech this time.... huge practice 27 docs and who knows how many other employees. I'm so confused.

Mine is a Biotronik if that makes any difference.

5 Comments

Medicare & You

by janetinak - 2007-11-20 02:11:05

I use the Medicare book title as I find it somewhat amusing (sorry I am not a happy camper with Medicare). I would call Medicare on the 800# on your card. I have done this recently about something my cardio wanted done to see if it need prior approval. I was told that Medicare pays for what Dr wants done. See if this works & document who, when, etc. you talked to in case they change their mind. I would not pay for this & doubt if your Dr can accept the money if accepts Medicare. Good luck.

$94.00

by scpck - 2007-11-20 06:11:48

Well that's not impossible, but it is a hunk of change on Social Security DIsability income.

That would be about 10% of my check. I called the Medicare number and they quoted a policy that basically said "it depends."

I am so not happy with my whole Medicare experience. I had ONE night of bradycardia. I got a pacemaker, because didn't know what else to do as they said that was urgently needed. I have had no arrhythmia episodes since. My cardiologist pats my hand and says all the above little old lady aphorisms.

If I could work, I would. Do they think that being on disability is FUN? I was making more in a day than I do in a month now. Grrr. Sorry y'all, but you'd think I would be able to defend myself better.

PM checks

by winelover - 2007-11-20 12:11:40

I have insurance through a major healt insurance co. here in the US - and between me and the company I work for, pay an arm and a leg for the policy - they will not cover a pm check more than 4 times a year, and there has to be 3 months in between checks. Even last year when the battery was running low and I had to have it checked more often, they refused. At my Dr. office a check cost $94.

Medicare pacemaker checks

by Susan - 2007-11-21 09:11:24

I would encourage you to go back to your doc's office and push this issue. I do not belive this is a Medicare issue but a billing confusion in your doc's office. I checked out my contacts for Medicare (I am a SHIP counselor) and came up with the following:

The decision as to how often any patient's pacemaker should be monitored is the responsibility of the patient's physician who is best able to take into account the condition and circumstances of the individual patient. These may vary over time, requiring modifications of the frequency with which the patient should be monitored. In cases where monitoring is done by some entity other than the patient's physician, such as a commercial monitoring service or hospital outpatient department, the physician's prescription for monitoring is required and should be periodically renewed (at least annually) to assure that the frequency of monitoring is proper for the patient. Where a patient is monitored both during clinic visits and transtelephonically, the contractor should be sure to include frequency data on both types of monitoring in evaluating the reasonableness of the frequency of monitoring services received by the patient.

Susan

thank you Susan

by scpck - 2007-11-22 01:11:13

I will call his office. I've for the most part felt great, but that's always. I did have that one fainting spell for which they never found a cause. I like the guy personally, but maybe familiarity is not so good in this case. I have known him from the hospital a good 10-12 years while he was training.

I wonder if it would work changing docs within the group? THere's another smaller cardiology center affilliated with another hospital. I might try getting a second opinion though my medigap doesn't pay for such. What do you think about that?

You know you're wired when...

You name your daughter “Synchronicity”.

Member Quotes

At age 20, I will be getting a pacemaker in few weeks along with an SA node ablation. This opportunity may change a five year prognosis into a normal life span! I look forward to being a little old lady with a wicked cane!