She came to do toes and nails at a cost of $30.
My husband and I never were notified that she had any service or asked is it okay she has this done until they billed us at the end of month.
We just received her bill with a pedicure service and a new patient form for a foot and ankle dr for us to fill out.
I asked what is this for? They said they got rid of pedicure lady and the foot dr will come to them and he will bill the insurance.
Can they make that call for her to be seen? When we haven’t been aware of any issues and I see this $$$.
I hope I haven’t confused anyone

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My mother has lived in an ALF for 6 years and has used the podiatrist who comes into the building every other month to clip her toenails. They don't like the beauticians to do it because if there is a nick or cut, and a person is on a blood thinner, they can have issues. Medicare pays for a podiatrist to clip the elders' nails once every other month, with a co-pay, if your MILs secondary insurance plan is set up with co-pays.

If you don't want your MIL to use this service, then don't fill out the paperwork and figure out another way to have her nails clipped. I find it convenient, and my mother signs herself up to be seen, or lets the nurse know she wants to be seen and they sign her up. The podiatrist bills me separately for the service when it's performed, after Medicare & BC/BS pays their portion.

You would need to ask your MIL if she requested her nails to be clipped. I find it pretty hard to believe it was done without her permission or without her approval/knowledge, etc. In Assisted Living, she has the right to make charges on her room as she sees fit and does not need your permission to do so.
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Does your DH have POA?  Does the contract with the ALF give them the right to do this.
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Elders cannot reach down to their nails to do their foot care. It becomes dangerous due to the fact that they heal poorly due to impaired circulation, and this becomes a medical issue. Especially if there is any diabetes or circulatory concerns. It is very GOOD to have periodic medical personnel to assess feet, nails, and do a trim, and yes, if they bill insurance all the better, but even if this needs to be paid, it is well worth it in prevention of problems ongoing.
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FloridaDD Mar 2020
I think Medicaid/Medicare pays for this.  No excuse for the NH to use a non-DR.  Of course, the MIL should get her feed examined, and it seems like there was no need for OP or her DH to pay.
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