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Social Security & Medicare

BittyJenkins

(594 posts)

2. I just went through the same thing

Reply to Susan Calvin (Original post)

Fri Nov 29, 2019, 05:29 PM

Nov 2019

My orthopedic doctor wanted me to have my vitamin D checked out because I broke my shoulder and it was not healing well. When I went for the test I was told medicare would not cover it. That one lab would have cost close to $300 out of my pocket. It all got down to the code. The lab called the office and asked them to change the code number to something that medicare would cover and they did. It is my first year on Medicare so I am learning too. All and all it has been great but you have to be aware.

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I just got an ABN from the blood test lab, and I am very confused. [View all] Susan Calvin Nov 2019 OP

That unquestionably sucks, but you are stuck with a Hobson's choice... TreasonousBastard Nov 2019 #1

I just went through the same thing BittyJenkins Nov 2019 #2

sounds like the doctor's office may have used an incorrect diagnosis or code on the written order yellowdogintexas Nov 2019 #6

Pretty sure it comes down to the code in my case. Susan Calvin Nov 2019 #11

Did you get the test???? dixiegrrrrl Dec 2019 #22

Thank you for asking. Susan Calvin Dec 2019 #23

Medicare pays for 80% of what is deemed "reasonable" CharleyDog Nov 2019 #3

Except Medicare providers are required to accept the amount Medicare says is reasonable - pnwmom Nov 2019 #4

not exactly how payment is determined yellowdogintexas Nov 2019 #5

The lab I went to did not even contact the doctor's office. Susan Calvin Nov 2019 #12

Susan it may have been some or all of the charges. yellowdogintexas Nov 2019 #7

I'm on traditional Medicare and TRICARE. Susan Calvin Nov 2019 #13

Medicare isn't shy about stating that if a provider won't cover the cost of a procedure then the abqtommy Nov 2019 #8

Wow, it sounds like you talked to some people at Medicare who are actually competent. Susan Calvin Nov 2019 #16

From my experience that is standard, if Medicare or any insurance for that matter doesn't cover still_one Nov 2019 #9

I'm not sure now, since they wouldn't give me a copy of the ABN, Susan Calvin Nov 2019 #14

I think your assessment is probably right. Regardless, if you need the results in orders to know still_one Nov 2019 #15

Thank you so much for the responses. Susan Calvin Nov 2019 #10

That is absolutely standard. PoindexterOglethorpe Nov 2019 #17

Actually, they had the cost right on the form they wanted me to sign. Susan Calvin Nov 2019 #18

Oh, good, I'm glad they had the cost. PoindexterOglethorpe Nov 2019 #19

You're probably right about the Medicare website, but I have had no luck so far . Susan Calvin Nov 2019 #20

Trust me, there is zero transparency about the cost of anything PoindexterOglethorpe Dec 2019 #21

That's for sure El Mimbreno Dec 2019 #24