Wellness

[Carmie]

@SeaMaiden   How would this plump up a doctor's pay check?  The doctor would not receive any more money for prescribing this.

[SeaMaiden]

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@Carmie wrote:

@SeaMaiden   How would this plump up a doctor's pay check?  The doctor would not receive any more money for prescribing this.

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 many doctors accept kickbacks from  medical companies  ( very common with Phamacutical companies)... not something discussed or talked about.... this is done all the time.   Is it right...  no, but it is done.

[GusMo]

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@SeaMaiden wrote:

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@Carmie wrote:

@SeaMaiden   How would this plump up a doctor's pay check?  The doctor would not receive any more money for prescribing this.

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 many doctors accept kickbacks from  medical companies  ( very common with Phamacutical companies)... not something discussed or talked about.... this is done all the time.   Is it right...  no, but it is done.

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Soooo not true. 
we cannot even accept note pads and pens from pharmaceutical reps. When I prescribe equipment, I have no idea if it's covered or not. That detective work is up to the patient and perhaps billing/insurance person in office. 

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@SeaMaiden wrote:

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@Carmie wrote:

@SeaMaiden   How would this plump up a doctor's pay check?  The doctor would not receive any more money for prescribing this.

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 many doctors accept kickbacks from  medical companies  ( very common with Phamacutical companies)... not something discussed or talked about.... this is done all the time.   Is it right...  no, but it is done.

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[Carmie]

@SeaMaiden 

Pharma and other suppliers now has to notify the government of how much money they pay to every physician every year.  A lot of this has stopped.  This is a much talked about subject.  

You can look up your doctor to see if he/she has accepted any money from Pharma and how much. This has been in effect since 2014. It is called the Sunshine Act.  If a doctor accepts more than $10, it has to be reported by Federal Law.

You can look up any provider and see if they are paying doctors on DollarsforDocs.

[Drythe]

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@SeaMaiden wrote:

I had both knees replaced in 2013, and had no blood clot machine....my Dr. said it was not necessary....and that is with both knees done together at once. So your Dr. must be plumping up his pay check.

 Always ask what is covered by insurance BEFORE accepting anything and assuming it will be covered.... you must be very proactive in your healthcare and not ASSUME ANTHING IS JUST COVERED because it is suggested.

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@SeaMaiden 

Or, it could be that you and @Goodie2shoes have different medical issues which require different treatments.  

[SeaMaiden]

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@Drythe wrote:

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@SeaMaiden wrote:

I had both knees replaced in 2013, and had no blood clot machine....my Dr. said it was not necessary....and that is with both knees done together at once. So your Dr. must be plumping up his pay check.

 Always ask what is covered by insurance BEFORE accepting anything and assuming it will be covered.... you must be very proactive in your healthcare and not ASSUME ANTHING IS JUST COVERED because it is suggested.

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@SeaMaiden 

Or, it could be that you and @Goodie2shoes have different medical issues which require different treatments.  

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@Drythe   I went to a very well known joint replacement hospital here.  They did not use ice machines or blood clot machines for ANYONE. 

[hckynut]

@Goodie2shoes 

From what you've said, I assume your surgeon did not prescribe a blood thinner after your TKR. After my wife's October TKR, her surgeon prescribed Eliquis/Pradaxa. She took this for, I believe 10 days post surgery.

Was a blood test done to determine your INR/PtoTime numbers? Having had 2 different episodes of PE(lung blood clots), I am very familiar with these readings and their importance in relation to blood clotting.

If I talk with my friend(my wife's surgeon) I will ask him if he ever prescribes this type of machine post surgery. I personally had never heard this from the many I know that have had a TKR.

Why Medicare seems it unnecessary for preventing possible blood clots? I have no idea, but I do know many older patients, are prescribed some temporary type of blood thinner, post many types of very invasive surgical procedures. I know several that were prescribed Lovenox thinner, which had to be put in via a syringe injected into the abdomen. I did that many, many times myself.

Curious to see what you find out, please post a followup.

hckynut

[Goodie2shoes]

A little update, more to come. So I am determined to find out why such an important piece of equiptment would not be covered so I called Medicare this morning and a very informed rep explained to me that they never recieved a claim from my insurance company and never would have because the insurance company is contracted to handle medicare claims and it's up to them as to what they will cover. If I had my health benefits strictly through medicare it may have been covered but insurance companies decide what they will cover and what they won't so basically I was given the wrong information. Now I have been with this insurance company for many many years, way before I retired so I decided to stay with them after I retired. The medicare rep suggested I call my carrier and speak with a supervisor.

I called my carrier, s/w a supervisor, explained what they're rep told me and what medicare said so she  contacted the compression machine provider and they told her they  contacted medicare who denied the equiptment and they would not be sending medical necessity to the insurance company. This is crazy ! and I intend to find out why it's not covered or get it reversed. So I called my Ortho's office, explained the situation, they will address the problem with the doctor and let me know the status of sending medical necessity to the carrier. 

[Goodie2shoes]

@reiki604  wrote: What kind of Medicare plan do you have? Is it an Advantage plan or straight Medicare with a supplemental, or just Medicare A and B? I believe different plans cover different things

I have AARP Medicare Advantage complete and I have had no problems until now

[Kachina624]

@Goodie2shoes.  It's a good thing you're retired and presumably have lots of time.