Anyone here do hospital appt scheduling? - Page 4

CelticCrafter · ‎03-09-2010

@Mz iMac wrote:
@ahoymate wrote:
@noodleann @Kalli

It's illegal & the medical practice should be reported to the State Medical Board.
MD's have the right to not accept medicare patients. Today, most want cash. No insurance of any kind. It's legal.
@ahoymate That is NOT the op issue. She is a long standing patient. What they are doing is illegal if she is correct in how she is being treated.

BTW: Yes a medical provider can refuse accepting NEW Medicare patients. Under the law, they must continue to treat their "current" Medicare patients. Cannot "kick them to the curb" so to speak.

While the OP maybe a long standing patient, she is a NEW Medicare patient. That could be the reason why the scheduler said not to tell anyone.

FiddleDeeDee · ‎03-06-2020

@Kalli To answer your question, yes. Reason? Reimbursement rates.

Another side of the same question: dear friends of my in-laws retired to Delaware. Love it. Bought a gorgeous place in a retirement community (all single family homes) and life is good. Except, they can't find doctors. He is a retired surgeon. She is a retired primary care physician. So, they travel to MD for all their appointments (many apparently do). Why? Doctors won't take on new patients on medicare due to low reimbursements. One of the issues the state is facing is so many people are retiring to Delaware that many doctors are finding the bulk of new patients are only Medicare. New doctors can't afford it and older practices want more money so....they leave the state. This leaves LESS doctors to go around so you have shortage and ....you get the picture.

It was an interesting discussion when this topic came up a year ago (they've been there 10 years now). I called MIL last night and mentioned this topic to her and she and FIL have faced this many times (she's a retired OR nurse). I asked if their friends in Deleware were still coming to MD for care and she said "OH yes".

As more retire, this will be something that will have to be addressed.

"Coming to ya from Florida"

Imaoldhippie · ‎06-10-2015

I would be very suspicious of her being booked for all of NEXT year. Also, I dont understand why you book office appointments though the hospital?

If they truly are booking appoints as to insurance coverage, age, paperwork involved, etc., I would change docs and hospitals in a flash no matter how much I like the NP.

BE THE PERSON YOUR DOG THINKS YOU ARE! (unknown)

kitty60 · ‎03-13-2010

Funny, DH and I alwyas scheduled our physicals as we checked out for the following year. It has happened he was able to and when I tried they told me they couldn't do it. At the time he was on medicare and I wasn't. During COVID my opthalmologist will not make the appointment when you are leaving as they don't want you in the area. They send a card and then you have to call and schedule.

Carmie · ‎10-25-2010

@Kalli wrote:
@Carmie wrote:
Medicare does not cover a yearly preventative GYN exam. It only covers one every 24 months.

All providers have appointments for well visits, but they have to keep appointment times open for people who have an urgent need.

If you have no medical issues, you don't have an urgent need.

No preference is given to anyone based on their insurance, but if your yearly preventative exam was denied as not covered because of the time period, you would be upset that they didn't tell you when you made the appointment.

I would make an appointment at the first available date and be done with it. Your younger friend probably has coverage for a yearly exam.....you don't.
@Carmie It was after my last appointment that I aged into Medicare. So this year’s appt is the first that will be covered by Medicare. During last yr’s appt my NP discussed that this first Medicare appt will be very important, with regard to certain assessments or tests that are easier to cover now than later.

For an urgent situation, I always accepted a time with whomever had an opening.

This is not an urgent situation. It is a check-up for which I qualify. Why should I give it up?

Good to know that no preference is given to anyone based on their insurance. I started to wonder because my friend was able to schedule a year in advance when I was told they couldn’t schedule any appointments that far into the future.

I do have an appointment for this year but that only happened because I was persistent and a kind person helped me.

Another thing to be aware of is that Medicare considers a routine GYN exam to be part of your routine well visit with your PCP. If you have a well visit with your PCP and prefer to get your GYN exam elsewhere, you PCP must use a billing code to reflect that. If not, you will get a denial for the GYN exam.

Of course, if you are having a problem, you can visit your GYN as often as necessary.

If you already had your Welcome to Medicare visit with your PCP, be prepared to pay for your GYN exam out of your pocket.

Kalli · ‎03-11-2010

@Carmie thanks for the additional info. I have original Medicare and was told I can schedule without my regular dr's involvement. The Med Center called to verify my coverage last week. But to be sure, after reading your post, I checked with my Medicare rep and she told me I'm covered.

I do appreciate all the information you've provided. Health insurance has always been confusing to me. But I was kinda spoiled because I always relied on my dad to keep it simple and navigate these issues for me. He was a retired insurance agent and understood the terminology and coverages. In fact, he used to offer free classes on Medicare at our local Area Agency on Aging. Sadly we lost him to complications of this cursed virus back in July.

Kalli · ‎03-11-2010

@FiddleDeeDee wrote:
@Kalli To answer your question, yes. Reason? Reimbursement rates.

Another side of the same question: dear friends of my in-laws retired to Delaware. Love it. Bought a gorgeous place in a retirement community (all single family homes) and life is good. Except, they can't find doctors. He is a retired surgeon. She is a retired primary care. So, they travel to MD for all their appointments (many apparently do). Why? Doctors won't take on new patients on medicare due to low reimbursements. One of the issues the state is facing is so many people are retiring to Delaware that many doctors are finding the bulk of new patients are only Medicare. New doctors can afford it and older practices want more money so....they leave the state. This leaves LESS doctors to go around so you have shortage and ....you get the picture.

It was an interesting discussion when this topic came up a year ago (they've been there 10 years now). I called MIL last night and mentioned this topic to her and she and FIL have faced this many times (she's a retired OR nurse). I asked if their friends in Deleware were still coming to MD for care and she said "OH yes".

As more retire, this will be something that will have to be addressed.

@FiddleDeeDee Wow! That's shocking to hear it's so difficult to get a dr's appt when you're on Medicare! But I don't doubt anything you said. I remember years ago my mom telling me some doctors were refusing Medicare patients.

I do have an appointment in November. I'll be asking my NP about this. Right now, I'm thankful to have this appointment as I know it's so difficult to get one with her. Not her fault, though. It's because she's so caring, compassionate and knowledgeable that everyone wants to go to her.

dulwich · ‎01-18-2012

@Kalli My experience when working in both large medical clinic and Drs office in CA our receptionists were told not to take Medicare or Medical new patients to say we were totally booked mainly due to slow payment - all about the money. This was how I saw it work in lots of Drs/clinics here in CA.

Was totally surprised - and pleased - when working in AZ how everyone accepted Medicare- no problem at all.

However, you are a long standing patient and they should re-book you.

Never ever heard or seen bookings made for all of next year. Drs do not generally know their schedules so far ahead.

I think you are being treated poorly as a long standing patient. Do not give up - speak with Office Manager or your Nurse Practitioner.

We all hated this practice of 'politely' refusing Medicare but it was always laid down by Head of clinic the receptionists were doing what they were told. I thought it had long gone by the wayside. Hope you get satisfaction as you should.

millieshops · ‎03-09-2010

I'm in my 15th year with Medicare and haven't had any scheduling problems because of it. In fact, just recently a friend who has my same Medicare provider told me she couldn't get an appointment with a doctor we both use until next May, so I called immediately to get scheduled. I got a March appointment. No real idea why the difference.

Carmie · ‎10-25-2010

@Kalli Did you have a Welcome to Medicare exam? If you did, you might end up getting a denial for that GYN exam.

Unless your Medicare rep checked your claims, she/he cannot tell you that your will be covered. Yes, you have coverage, but if you already used that benefit, it will not be covered.

I worked in CS for over 25 years dealing with health insurance, including Medicare claims. I have heard many people crying on the other end because they were told that something would be covered and it wasn't.

I hope all goes well for you.