NA 'Medicare won't pay for that'

[Let'sgoflying!]

Elderly person, bonafide illness, Dr. ordering multiple tests in order to track down the cause. Still not elucidated, so more involved tests follow.
Sick person gets notice from Medicare saying they won't pay for a certain test (imaging).
Did I read Medicare plays the 'who will roll over first' game and it should be contested?
Any other tips on dealing with them?

 

[Becky]

Yes, they tend to resist but are not impermeable. Resubmit, or ask office of provider to resubmit. Those in the health care industry usually know how to break through that wall.

But some weird new rules are creeping in. My mom is dealing with osteopenia by exercising, using supplements, and having an excellent diet, and is actually gaining bone strength! But because she is NOT taking a bone building drug, the latest DEXA is not covered. I would not have believed it if I hadn't heart them say it on the speakerphone when I was at her house.

 

[weilke]

Elderly person, bonafide illness, Dr. ordering multiple tests in order to track down the cause. Still not elucidated, so more involved tests follow.
Sick person gets notice from Medicare saying they won't pay for a certain test (imaging).
Did I read Medicare plays the 'who will roll over first' game and it should be contested?
Any other tips on dealing with them?

PM me with the test, the current diagnosis and the location of where this happened. I'll try to look up the 'local carrier determination' that applies. May just be a billing error.

 

[Everskyward]

Let's keep the politics out of this thread. Some posts were deleted.

 

[SkyDog58]

I have not had any experience in dealing with Medicare but if they are like any other government bureaucratic organization, sometimes it just takes perseverance in dealing with them to get the correct or desirable end result. Good luck.