Home Health Medicare Opt Out

[rousemark]

Just so this doesn't get lost. There are 3 types of providers for Medicare billing:

3. Excess Charge Providers. They do not accept assignment AND have not legally opted-out. Usually they file claims and wait on payment from the carriers if the insured has Plan F or G. If its N, its not covered. Sometimes, they want their "excess" money upfront. In reality, they can do whatever they want. Had 2 claims in TX in 20+ years. But in Arizona, Mayo Hospitals do not accept assignment and you better have G or its going to be ugly.

Even though they do not accept assignment, their charges are limited to 15% in excess of the Medicare approved charges.

 

[rousemark]

This is 100% total, unadulterated BS.

1. The senior, in the middle of a health crisis, is told to use this Home Health Agency from the hospital.
2. The Home Health Agency may or may not had her sign a form showing they weren't covered under Medicare. Which is exactly what our seniors need in the middle of a health crisis.
3. When she asked, they lied to her. (That's a complaint to the state HHS, BTW)

TX and CA answer on Home Health: I don't know of any that do not accept assignment.

Don't throw anything at me answer: This is when MAPD works better than OM. Assuming they actually approve the Home Health.

Let me know if you need to call and yell at someone. This is unconscionable from top to bottom. The hospital who arranged the Home Health. (Kickbacks, perhaps?) The social worker at the hospital should have her license pulled. The Home Health Agency needs to be investigated.

Want to fire me up? Take advantage of seniors when they are sick.

How many just automatically sign whatever form the hospital puts in front of them without reading it? Or, at best just accept whatever explanation of the form that the clerk provides them? I would almost bet that the HHC has a signed contract that they aquired in some manner.

 

[somarco]

This is unconscionable from top to bottom. The hospital who arranged the Home Health. (Kickbacks, perhaps?) The social worker at the hospital should have her license pulled. The Home Health Agency needs to be investigated.

I will put you down as undecided on this matter . . .

Just curious. Do you have a bullseye painted on your back by any chance? They seem to be looking for you.

Not necessarily . . .

I do get phone calls from out of the blue that are complete time wasters. Those calls are dispatched in 5 minutes most of the time.

Referrals from clients are different. I take those and treat them as if they are a client . . . even if I will never get paid for anything. You might be surprised at the number of referrals I get from those folks who know I am not getting paid, but many times they will send me other folks where I can make a few bucks.

What goes around comes around.

 

[somarco]

How many just automatically sign whatever form the hospital puts in front of them without reading it? Or, at best just accept whatever explanation of the form that the clerk provides them? I would almost bet that the HHC has a signed contract that they aquired in some manner.

I dare say there are a lot of folks who never read anything before signing. Even more so when a doctor, or someone at the hospital, says this is what you need to do . . . we can have the provider contact you if you want.

How many folks buy insurance, in person, on the phone or online based on what they are told, what their friends suggest, or what they think they need?

If more people took the time to read, ask questions, and research before buying something as complicated as health insurance there would be a lot less buyers remorse.

I have friends, relatives and even clients that will do whatever the provider says without question.

SMH

 

[kgmom219]

I will put you down as undecided on this matter . . .

Yeah. Good plan, just in case you were wondering how I feel about crap like this.



What goes around comes around.

YES!!! Help everyone. You never know what will happen next and for 9 months of the year, we certainly have the time and expertise.

 

[Duaine]

This is 100% total, unadulterated BS.

1. The senior, in the middle of a health crisis, is told to use this Home Health Agency from the hospital.
2. The Home Health Agency may or may not had her sign a form showing they weren't covered under Medicare. Which is exactly what our seniors need in the middle of a health crisis.
3. When she asked, they lied to her. (That's a complaint to the state HHS, BTW)

TX and CA answer on Home Health: I don't know of any that do not accept assignment.

Don't throw anything at me answer: This is when MAPD works better than OM. Assuming they actually approve the Home Health.

Let me know if you need to call and yell at someone. This is unconscionable from top to bottom. The hospital who arranged the Home Health. (Kickbacks, perhaps?) The social worker at the hospital should have her license pulled. The Home Health Agency needs to be investigated.

Want to fire me up? Take advantage of seniors when they are sick.