Doctor's office gave me a reason for dropping me that I know is untrue. I believe they're dropping me because they don't want to take my Medicare anymore.
JohnMack, if you haven't yet contacted the "rejecting" doctor's office and spoken directly with the billing person or office manager to correct the error, I would write a letter to the doctor informing him of the screwup. Mark it personal and confidential so it goes only to him.
I'm assuming that the cardio's bill hasn't been paid by Medicare? I would alert that office as well; they could contact the referring PCP's office and get action and correction probably quicker than a patient.
I have a suspicion the PCP's office has someone new on the billing team and this person didn't check the records to see that the PCP was the referring doctor.
Thankyou very much. That was the type of information I was hoping for before I did contact the office. Medicare has paid their portion of the cardio bill.
Did you change from straight Medicare to a Medicare Advantage? If so, that maybe your problem. The word "Medicare" in Medicare Advantage is very misleading. Medicare contracts out with these MA insurance Co. They are suppose to abide by Medicare criteria but the problem that arises is...MAs have their own network of Drs. Your doctor may take Medicare but he is not in the MA network of doctors. So, he is not able to bill the MA.
The only way that your PCP would know you changed doctors is if that doctor requested your records. Someone in his office may have made a mistake when it came to your heart doctor. I would call and explain that you have not seen another PCP. The only doctor you have seen is a heart doctor that the PCP referred you to.
Their reason exactly is: 'the reason for this discharge is that you have established care with a different Provider'. That is completely incorrect. Since I have been seeing this doctor's office I have not seen or pursued another PCP. The only other physician I have seen since then is a cardiologist that I was referred to from this same doctor's office.
Also if you are on a “Medicare advantage” plan, your doctor may not be in network for your plan. If you go to “lower cost” Medicare advantage option, you can lose access to certain doctors. Just because a doctor takes Medicare, it doesn’t mean they take YOURS; and many of them are restricting number of patients they have with new payment rules.
Yep, they sure can. Medicare pays practically nothing, and they're very strict about how doctors bill them. My mother's doctor was actually kicked off Medicare (or so she claimed) because she billed them for more time with her patients than they allow. (Yes, she spent at least a half-hour with her patients, but she was also a lousy doctor in other ways. Good listener/terrible diagnostician.)
Medicare is like any other insurance, and doctors can choose not to take it. Most who don't do so because they can't make any money off Medicare. My chiropractor told me straight out that she is paid $19 per visit by Medicare, and she charges my insurance $120 per visit just to make up the difference on what she's losing on her older patients.
JohnMack, it is not unusual for a doctor to drop out of accepting all patients who are on Medicare, even if they have been accepting clients in the past.
Here's a good article: https://khn.org/news/concierge-medicine-how-to-find-primary-care-doctor-when-physician-opts-out-of-medicare
So sorry this happened to you, especially if you liked that doctor. When looking for a new doctor, when you call their office ask if they accept Medicare patients. Some doctor's have quotas on how many patients they can take.
Some doctors don't take Medicare though. I'm assuming that this isn't one of the concierge doctors, who treat the wealthy and choose their clients selectively?
I'm assuming that the cardio's bill hasn't been paid by Medicare? I would alert that office as well; they could contact the referring PCP's office and get action and correction probably quicker than a patient.
I have a suspicion the PCP's office has someone new on the billing team and this person didn't check the records to see that the PCP was the referring doctor.
Good luck.
The only way that your PCP would know you changed doctors is if that doctor requested your records. Someone in his office may have made a mistake when it came to your heart doctor. I would call and explain that you have not seen another PCP. The only doctor you have seen is a heart doctor that the PCP referred you to.
Medicare is like any other insurance, and doctors can choose not to take it. Most who don't do so because they can't make any money off Medicare. My chiropractor told me straight out that she is paid $19 per visit by Medicare, and she charges my insurance $120 per visit just to make up the difference on what she's losing on her older patients.
Here's a good article: https://khn.org/news/concierge-medicine-how-to-find-primary-care-doctor-when-physician-opts-out-of-medicare
So sorry this happened to you, especially if you liked that doctor. When looking for a new doctor, when you call their office ask if they accept Medicare patients. Some doctor's have quotas on how many patients they can take.
Some doctors don't take Medicare though. I'm assuming that this isn't one of the concierge doctors, who treat the wealthy and choose their clients selectively?