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General Discussion

Ms. Toad

(35,640 posts)

12. Unless the care has non-covered uses, or is experimental,

Reply to Southern_gent (Reply #10)

Fri Dec 27, 2024, 03:43 PM

Yesterday

An advance review isn't even required for Medicare coverage.

We (n=4) have encountered exactly one treatment that required advance review (cosmetic surgery overlap) in a cumulative total of 65 years of experience.

As a general rule, that explanation doesn't make sense, especially with garden variety distressed like colorectal cancer.

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Denial of Care [View all] Southern_gent Yesterday OP

Sorry about doc's illness. But it's about time folks realize Medicare denies claims too. In fact, most insurers Silent Type Yesterday #1

Following... Sedona Yesterday #2

He should call his US Senator's office if they aren't rapublicons SheltieLover Yesterday #3

Maryland's senators are Democrats Wicked Blue Yesterday #6

It depends on the policy of Medicare. Jacson6 Yesterday #4

That's crazy. Mosby Yesterday #7

They only cover pap smears every other year. LeftInTX 22 hrs ago #13

The GFM says "Medicare part B termination" LeftInTX Yesterday #5

I'll have to read more carefully. Ms. Toad Yesterday #9

there is a maximum radiation allowed rampartd Yesterday #11

It's not a hard limit. Ms. Toad 21 hrs ago #14

Something is fishy here. Ms. Toad Yesterday #8

My son knows this physician and the person Southern_gent Yesterday #10

Unless the care has non-covered uses, or is experimental, Ms. Toad Yesterday #12

Doctors know experimental and non-covered treatments will get denied, or they learn quickly. Silent Type 21 hrs ago #16

Which is why, as a general rule, Medicare does not deny claims. Ms. Toad 20 hrs ago #17

So, in other words, the OP example is just another case of a patient griping about denials when it's their own fault. Silent Type 7 hrs ago #18

I don't know that it is their own fault. Ms. Toad 7 hrs ago #19

From Dr. Zollicoffer, himself: Ms. Toad 21 hrs ago #15

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