My mom was recently discharged from a hospital with an order for home health to follow. This included RN, PT and OT. She has VA for her medical but in this case needed to go to the closest hospital. There was mention of a mobile physician going out to her home-I declined as I was setting her up with the VA to follow which included blood draws, MD, RN. Anyway, because my mom was not 100% alert...they ordered this. My mom did not have a clue who was coming and going. Long story short.....she has about $1500 dollars to pay that Medicare would not pay for. This is for the MD visit that wasn't VA and the lab draw that also wasn't VA. She doesn't have money...they are on a very limited budget. Anybody out there have any suggestions for this?

Thank you and bless you all.

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Just curious, what is Medicare's reason for not paying for the service? We have a visiting doctor and pretty sure Medicare pays for the service. And the OT, PT should be covered.
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JoAnn29 Jan 2019
Still thinking...does the VA bill Medicare? Is that why Medicare turned down the other agencies billing? The services had already been paid for?

Was no one with Mom when the Mobile agency admitted her? Same with the second PT, OT people. There has to be an admittance process.
I think TNT sets out a good and courteous approach. This ineligible service was provided without competent authorisation, is the long and short of it, and frankly they shoulda thunk of that before.

Have they got your mother's signature on anything? If so, you'll need to argue that she wasn't capable of consenting at the time. If they insist she was, you point to the fact that they had been liaising with you throughout and therefore knew perfectly well that your mother was not in command of the decisions.

Anyway, you refused the service, she wasn't with it, and you had also explained to them that you were in the process of organising the recommended follow-up through her authorised providers. It's their error.

Hmm... did they tell you that they had ordered the visit once they'd done it but before the visit happened? Or was the bill the first you heard of it?

$1500 for a home visit and set of bloods! Yowch.
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Since you declined the services initially and there was an apparent second approach to an ill and possibly medicated elder, I would write a nice letter to the mobile physicians stating these visits and tests were unauthorized and the enclosed bills are superfluous; please close these accounts and do not contact again concerning this matter. I would then send a copy of all that to the hospital inquiring about the hospital's relationship to the mobile physician practice and if the hospital receives any fees for directing patients their way even after services have been declined.
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