I appealed for my father, and I believe, but don't remember for sure if I had Dad countersign the letter I wrote. Medicare never challenged my authority, but it did drag its feet on a final decision, fooling around for a year or so, then denying the appeal, which I promptly re-escalated. I never heard anything after that. Medicare just didn't respond. And the hospital just wrote off the charges.
I know that I never sent Medicare any DPOA copies, nor do I recall that they asked for them. But if I did have Dad countersign (to the best of my knowledge), that might have changed the situation.
Medicare pay a bill, saying it wasn’t noted as medically necessary. I need to get a letter from the dr saying it was, I have to call the dr for this. But medicare says they won’t let me appeal it because Im not listed as able to handle Her medicare and social security (not their exact words, but basically). And they don’t accept Poa because they have their own form for her to authorize me to handle her medicare (government always has to complicate things) But she’s in memory care and I don’t think she could authorize me at this point. In honesty if I asked her to sign something,she trusts me enough to do that,but I just don’t feel that’s right (or legal).
Really, so what do they need? How are you suppose to do business for a Dementia patient.
Lets go this way. Are you questioning what Medicare was charged or what they paid because Medicare will tell you they don't make mistakes.
The provider charges lets say $1000. Medicare pays 80%, $640, of what they feel is reasonable, $800. That leaves a balance of $160 that hopefully the secondary picks up but with copays and deductibles that may not happen.
The provider has to except what Medicare pays them, $640, and can go after the balance of $160 if not picked up by secondary.
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I know that I never sent Medicare any DPOA copies, nor do I recall that they asked for them. But if I did have Dad countersign (to the best of my knowledge), that might have changed the situation.
You probably need to be the payee for Moms SS. Call SS and tell them the problem ur having. You can't be the first one with this problem.
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Lets go this way. Are you questioning what Medicare was charged or what they paid because Medicare will tell you they don't make mistakes.
The provider charges lets say $1000. Medicare pays 80%, $640, of what they feel is reasonable, $800. That leaves a balance of $160 that hopefully the secondary picks up but with copays and deductibles that may not happen.
The provider has to except what Medicare pays them, $640, and can go after the balance of $160 if not picked up by secondary.