What A Flipping Racket.

CrazyKittyLvr2 · ‎05-11-2013

When I had my TKR on 11/20/2019, of course I couldn't drive as it was my right knee. I had a home health woman come very other day for 2 weeks. Plus 1 day the 3rd week.She did the BP, checked my incision etc. The 1st day she gave me exercises to do.

I did not go to outpatient PT because the place I wanted to go had a fire and were shut down. The only other option was where I did my pre-op PT when I had my hip done in 2018. I was not impressed with them at all.

My Dr. said I could just do my exercises at home.

Anyway, I got a Summary Notice (for Part A Hospital Ins) from Medicare. For 7 visits in which I didn't do any exercises with her here was $2,750.00. Oh,she watched me do the stairs once.

I did the exercises 3 times a day, morning,noon and night. She came between the morning and noon times. Was here maybe 1/2 hr. and then left. 3 and 1/2 hours total time over 2 weeks and 1 day.

I was in the wrong line of work before I retired.

on the bay · ‎03-09-2010

@CrazyKittyLvr2 -

I'm sure that is how they get lots of money by putting things, supplies, treatments in that were never done.

some is routine, like something they may put in every room, or assume is done with every respiratory therapy etc.

It is also amazing how if you are able to read doctors notes on a visit, how many things that are just false and you never said or had done!

My mother is maybe one of few who do this, but she actually goes over every line of the bill and calls and disputes it if she didn't think she got it or it happened. And she doesn't pay for it because she has medicare and great insurance, only copays.

She catches a lot!

It really is awful.

"If you walk the footsteps of a stranger, you'll learn things you never knew. Can you sing with all the voices of the mountains? can you paint with all the colors of the wind?"

Kachina624 · ‎03-10-2010

Medicare reimbursements are so low, providers have to cheat in order to break even. I can't believe how little they pay a doctor.

You have the right to protest any illicit billing. I believe Medicare encourages you to do so.

New Mexico☀️Land Of Enchantment

Group 5 minus 1 · ‎03-11-2010

Years ago and I mean years we had a patient who recorded (in a notebook) the amount of time her doctor spent on a hospital visit,when she got the bill she told him and not quietly that she did not consider poking a head in your room and saying "Hi" a hospital visit.

HerRoyaLioness · ‎03-13-2010

What was the Home Health persons's status? CNA, LPN, RN, Physical therapist?

It can make a difference in the billing.

If she touched you, took vitals and gave you exercises, it can be billed, but it depends how they billed it, as a home health visit or PT visit?

It sounds like this was being done in your home? Then Medicare Part A shouldn't be billing you if the place of service was at home.

I would call and ask about this.

Mom2Dogs · ‎03-09-2010

My mom was a nurse and always said if you are ever hospitalized go over the bill with a fine tooth comb. I had an outpatient surgery years ago and did just that. The charge I found and called about was legit but I didn't know what it was, and sounded off to me.... and wanted to know before I paid for it.

DH is on Medicare and we carefully watch those bills and match them up with the actual bill from the facility.

Maltichonmom17 · ‎04-22-2010

Questionable insurance billing has been going on for quite awhile unfortunately. Back in the 90s during the HMO insurance era, I had a new doctor and my first visit was a sick call. I had the flu and then started having econdary respiratory complications. At his office, he literally did nothing but take my BP and listen to me breathe. I was there maybe 10 minutes. He said I had pneumonia, handed me a prescription and sent me on my way.

A few weeks later, I received an itemized statement from the insurance company detailing numerous diagnostic tests and X-rays that this doctor had supposedly performed. I called my insurance company and alerted them to the fact that none of the testing he was billing them for had happened. The person I spoke to thanked me for taking time to report it and then explained that while they knew these things were happening quite often, it was more cost effective in the long run for the insurance company to overlook the deception and just pay the bill than to investigate it. I was just stunned.

lovemyparrot · ‎08-13-2011

Hi, OP, if you are a retired legal secretary (as I am), you will know how many items on a bill from an attorney are added in, how many phone calls you made on behalf of the attorney, how many legal documents you drew up and produced for the attorney to quickly scan through and sign, and on it goes.

Yes, its a racket, but not unusual at all in the health industry, legal services and lots more.

tsavorite · ‎03-09-2010

@Maltichonmom17 wrote:
Questionable insurance billing has been going on for quite awhile unfortunately. Back in the 90s during the HMO insurance era, I had a new doctor and my first visit was a sick call. I had the flu and then started having econdary respiratory complications. At his office, he literally did nothing but take my BP and listen to me breathe. I was there maybe 10 minutes. He said I had pneumonia, handed me a prescription and sent me on my way.

A few weeks later, I received an itemized statement from the insurance company detailing numerous diagnostic tests and X-rays that this doctor had supposedly performed. I called my insurance company and alerted them to the fact that none of the testing he was billing them for had happened. The person I spoke to thanked me for taking time to report it and then explained that while they knew these things were happening quite often, it was more cost effective in the long run for the insurance company to overlook the deception and just pay the bill than to investigate it. I was just stunned.

Wow....what would have happened if you had gone to have a chest x-ray a few days later somewhere else? wonder if that claim would have been denied due to the previous doctor submitting flase charges for x-rays.

mousiegirl · ‎03-09-2010

@CrazyKittyLvr2 When I had my hip replacement twenty-three years ago, my doctor didn't believe in PT, so had me do exercises from bed, free, and no stress for me.

It is shocking what the medical profession charges, even took my own meds to the hospital once, and was told that I may as well take theirs as I would still be charged. Next time, if any, hope not, I will take mine and not tell anyone, just sneakily take them.