I think you missed the part whereby WE DID NOT accuse them of fraud. We only wanted, and kindly asked for numerous times, for a readable bill and they refused to give us one.
Are we supposed to let the problem only worsen *by not questioning things*? Being doormats? Which only exacerbates the problem that already exists. If my a*s was covered 100% and *I* was not having to shell out what I have to... I would probably just go along. It's always easier just to go along isn't it??? The problem with that is that more and more people walk all over you. And they will walk all over others. Constantly taking advantage of the elderly also and robbing them of their life savings. I had a huge problem with a home infusion Co. as well. The owner said that he would only charge me $500 (as I was a second customer giving him business) but that changed when his billing department changed and he eventually turned us in to a collection agency. We were getting a bill from them for $1500 for all the paraphernalia that Medicare does not cover. BUT ... if I need them again they better not refuse to give me what the doctor ordered or they will be in court. And we have saved everything (paperwork). Bottom line... does everyone here want to remain sheeple? I don't think the quad list will let me attach a photograph of an example of sheeple so if anyone does not have it and wants it... e-mail me separately with the subject changed to SHEEPLE or I will miss it. Or perhaps you can google it and see it online somewhere. I almost missed this post from John below to respond to. Lori On Tue, Jul 1, 2008 at 2:09 PM, John S. <[EMAIL PROTECTED]> wrote: > I don't doubt a word you say, but I have never had a doctor get what > Medicare owed them. I know a lot of people think Dr.s should be paid the > same as barbers. My doctors have also employed relatives. Why not? Nepotism > is a problem in police forces and government, not a doctors office. My > doctor charges $80 per visit and Medicare pays him $42. My podiatrist will > get $66. The vet gets $65. The insurance company flips a coin and if the > doctor wins, he gets the coin. > Medicare fraud to me is when I am told I'll soon be using a Pride Jazzy. > My Waiver representative is an atheist so to save gas she calls me each > month to see if I'm alive and have I started jogging yet? A usual litany of > questions regarding each others lives and g'bye. On occasions I have had bad > doctors. A urologist in fact. I did report him to Medicare, but I'm sure he > still practices medicine. > I would not expect the doctor to set up more appointments if I just accused > him of fraud! This accusation is a doctor/patient relationship killer. Some > Doctors are so good they do make millions. I do not resent a single dollar. > If you accuse the medical system of malpractice and fraud very often, you > will start having trouble seeing doctors that are not in an Emergency Room. > You won't find anyone that wants to work for while you accuse them of > federal crimes. Your name will get around and you will be going to Dr's that > only see Medicare cases. > I've seen doctors submit very large bills to Medicare that I thought were a > little steep. This guy is 44 years old and still paying student loans from > hell while trying to raise a family and after the insurance company is > allowed to price fix against doctors, Medicare undercuts him by 70% and the > rest are too poor to even send an X-mas card, then he has to buy malpractice > insurance that costs him so much that many really good doctors only work for > drug companies. > Now, just to show how stupid they can be, congress has decided it will cut > any doctor bills by 10 percent. Why not cut what tort lawyers get by ten > percent. Cut the amount lawyers get from Medicare by 10 percent and save big > money. Cut back all payments from the US government to lawyers until the > budget is balanced! We will have a balanced budget in 6 months. > Treating Doctors as if they cause health care problems is the DUMBEST thing > congress has done since passing the Patriot Act, and ranks with the meanest > thing since forcing Japanese Americans into intern camps. Why not force Oil > corporations to cut prices by 10 percent? Because of their honesty? > We have found the line between good and evil and made a mad dash to the > wrong freakin side again! > > john > > ----- Original Message ---- > From: Lori Michaelson <[EMAIL PROTECTED]> > To: quad-list@eskimo.com > Sent: Monday, June 30, 2008 8:18:07 PM > Subject: [QUAD-L] Medicare fraud is blatant but is not being stopped > > Todd ... here I will get to what I found out is happening more and more AND > in one doctor's office in particular (further below my first-hand experience > which I talk about first) regarding Medicare fraud or theft. Same > difference. > > I know long e-mails are laborious to read but I hope that many of you DO > read this for yourself, for your parents, for your grandparents or whomever > who will probably, in some way and some time, fall into these traps. > > FIRST THOUGH -- Here is one of my first-hand case scenarios with a doctor's > offices getting away with double dipping *Medicare *and getting away with > it. > > I had a primary care physician here four years ago. My husband was also a > patient of his. Had him abt 2 yrs. Neither of us go to the doctor's office > that much but it does not even have to take that to let me/us see what is > going on. Whenever I DID go ... I would receive their bill and what they > billed *Medicare* for. And then I would have to wait for CMS's Medicare's > Explanation of Benefits to see what my responsibility of the bill was. > > Well, the last bill I received from this particular doctor (for a visit of > mine) was so screwy you could not even read what was what. My husband > called and asked for a bill that was more itemized and readable. They > disagreed that there was anything wrong with their billing statement. > Heanen forbid! My husband called because he is better at dealing with > people... especially those that are trying to lie to your face. The other > problem we saw was that the bill was SO VERY screwy but it was also set up > to be able to *double dip* in getting Medicare payments. In other > words... getting paid twice by Medicare. > > I get a tiny bit of help from a home health agency paid for 100% by > MediCARE. I'm getting robbed of over 98% of what I am eligible for but that > is an entirely different story. Anyway, every 65 days I have to be > recertified to make sure that I am still a quadriplegic (ha ha - ho -ho)and > still in needof home health help. The home health agency sends my physician > a sheet of > paper for him to sign and date that I am still in need of services every 2 > months for this recertification. And that is ALL a physician has to do... > sign one and date one. Every 65 days. > > MEDICARE, for approximately the last six years now, *has allowed > physicians to bill Medicare for their signatures!!!* And it is not just a > small amount. It is close to $200 or more! Absolutely crazy! But that's > the federal government for you! But it gets worse. > > What is so ironic is that *Medicare *has a fraud hotline. But it is a > joke. They are also federal government employees and nothing gets done even > if it is reported. Anyway, when we noticed on the bill that my doctor's > office was billing Medicare twice for my 65 day recertifications over a 9 > month period ... I again asked for an itemized, readable bill. The bill was > a mess *but that was to throw off* Medicare fraud being perpetrated by > doing this. When my husband asked why their office was billing Medicare > twice -- they had a fit to be called on it. No surprise there. And > then the billing clerk accused my husband of accusing them of *Medicare > *fraud. > Which he never did. I might as well say here that... guess who we found out > his billing clerk was (later via the receptionist)??? HIS MOMMY!!! > > GET THIS - by this last action of ours (questioning the bill) - it was not > a week later where we got a letter from the physician's office saying that > we "had breached the patient/doctor relationship" and that we needed to get > new doctors within two weeks! *DUMPING BOTH OF US* because of questioning > their billing! This is the honest to God's truth and, since then, I have > found out that this type of of thing is running rampant. I will tell you > how I found out next. > > OK ... NEXT ... :-) > > Approximately 2 months ago when my home health nurse was here to change my > catheter... we began talking about Medicare fraud and I told her what > happened to us four years ago. She was not surprised in the least. > > First of all, MOST *MediCARE* recipients and patients are people over the > age of 65. And it is the elderly who are the meek and never question > anything for fear of losing what they have. Or they are usually easily more > conned by these *Medicare* Dr. con artists. They trust their doctors, the > billing, and just pay their bills. > > So here is what I nurse told me: > > She told me this was not the first story she heard of such events. IN FACT > she told me *that what happened to me* (inquiring about their bill and > then being told that they had breached the patient-doctor relationship and > to have to find new doctors) had just happened *to one of her > other patients* ON MEDICARE. An elderly person. > > But she told me one MORE thing that was very disturbing to both her, and > then after telling me, very disturbing to me. Because of one of her > patient's experiences she found out that there is DEFINITELY one doctor's > practice here in town that ONLY accepts *Medicare* patients. Hmmmm... > wonder why? Obviously, most of the patients are over 65 and don't question > bills. Padding their pockets nicely. > > My nurse told me that she had been familiar with this particular doctor's > office [of probably three physicians] and would never have suspected that > they would be doing what happened to her patient of theirs like another > practice did to me. > > People can complain until they are on their deathbed. I have been calling > about Medicare discrimination and fraud and all one gets is the run-around. > Doctors have become wolves in sheep's clothing and getting richer and richer > and richer off the disabled and elderly ON *MEDICARE.* > > Last August, an emergency room doctor's office tried to get away with > pretty much the same thing by FIRT billing me directly and not *Medicare!* > Which is always the protocol - billing *Medicare* first. The office clerk > tried to tell me that I was responsible for the bill and other garbage*but I > was not going to buy it/fall for it. > * Much later I did get a CMS statement and he billed Medicare for two > different things! > > The bill that was sent to me was $128. When I told them I was not > responsible for that full payment and they had to go Medicare (which they > already know but are trying to pull the wool over people's eyes with any > story) she backed off. THEN I saw that he had billed *Medicare* for $368 > for one thing and a smaller amount for another thing. > > So doctors, hospitals, clinics, etc. are definitely getting paid more by > the *Federal Medicare* program but it is the feds to set it up that way to > begin with! I was flabbergasted when I found out that they started allowing > physicians to bill them a hefty amount for just a signature and a date. > > Lori > > -- > Lori > C4/5 complete quad, 28 years post > Tucson, AZ > > > -- Lori C4/5 complete quad, 27 years post Tucson, AZ
