10 replies to this topic

[goose]

This is for anyone on Medicare......

I was talking with a friend whose mother had recently fell and broken an ankle. She went today to have the cast removed and while there asked the Orthopedic surgeon to look at her shoulder which had started hurting from struggling with the ankle. She was informed she would have to make another appointment for that since it was a new injury. Apparently, Medicare has started a new rule beginning this year ...1 problem per visit. Has any one else had to deal with this? She wasn't even allowed to make the appointment on her therapy day since it was in the same office.

Is this just a money hungry doctor or is it really a new Medicare rule?

If it's a new rule, have they gone crazy? The only ones to benefit would be the doctors....NOT Medicare or the patients!!!

[Tim13]

There were a ton of new rules in Medicare this year, they are somewhat confusing (to me) but one problem per visit does look like it's in there.
It's probably designed to help doctors manage their time better in an effort to prevent fraud and waste.
Doesn't seem fair to the doctor or the others who are waiting for their appointments if someone schedules one thing and wants to add a bunch of other stuff once they are in the office though..

Edited by Tim13, 25 January 2012 - 01:17 PM.

[dreamerr]

I had heard about this years ago before I was on medicare. When I was going to pt I often heard them say I can't deal with that injury because you don't have a script for that. I only heard that with the medicare patients not the others. I assume it is a liability issue as well as a money issue. I am not sure if it is new or not but I didn't see it in the new medicare paperwork which doesn't mean it wasn't there hehe.

[DannyR]

I hadn't heard about this. I wonder how that will work when I have my own insurance also...will I still be able to talk with my dr. about more than one problem? I don't understand how that could save money when they would be paying for 2 office visits instead of one. Maybe it helps with tracking ones condition so that they aren't trying to double up on tests because they don't like what they hear from the first set of tests. There has to be a reason for this.

[Stand]

Fantastic news! Getting ready to go on Medicare February 1 of this year. I also heard just today that they are horrible when it comes to buying equipment, such as a wheelchair, and really only provide for the bare minimum. Can anyone tell me if this is true?

[goose]

Tim13, on 25 January 2012 - 01:15 PM, said:

There were a ton of new rules in Medicare this year, they are somewhat confusing (to me) but one problem per visit does look like it's in there.
It's probably designed to help doctors manage their time better in an effort to prevent fraud and waste.
Doesn't seem fair to the doctor or the others who are waiting for their appointments if someone schedules one thing and wants to add a bunch of other stuff once they are in the office though..

Maybe I'm the only one who sees the new rule as a waste of money. When I make an appointment, I'm always asked "what's your problem?" I feel they should schedule enough time to treat my problem or problems during 1 visit. So many doctors give multiple people the same time slot which causes longer waits. More than 1 visit takes extra time doing vital checks before actually seeing the doctor . Also more paper work on both ends....doctor and Medicare...more postage and paper sending statements and claims. Have you seen all the pages they send now? It's like a mini novel.

What about the time the doctor uses to refresh himself with your chart? The waiting rooms will have more people and appointments will be harder to get.


This new rule doesn't even consider the patient . If I'm needing to see a doctor, I'm not feeling well. The aggravation of getting ready and the fuel to get there( some doctors may be out of town) was not considered. What about if you have to take time off from work?


I see this as fraud. Your going to be charged for 2 office visits which is a min. of $125 per visit. Most doctors only spend a few minutes with you any way regardless of your problem. I see this as another way to abuse the system.

Edited by goose, 26 January 2012 - 04:54 AM.

[edlee]

No way, Goose,., Not a rule, regulation or anything else,,, this according to my doctor,, who I talked to today. The reason I asked him about it was because my brother,,, who happens to be a staunch anti-Obamaist,, told me this last week. So, I asked my doctor,, who ALSO happens to be in the same club. So, you might say I got it from someone whose affiliations might be thought to make him more easily believe it.

BUT,, as complicated as the regs are,,,, it may take months to get it figured out. It does strike me as being in the doctors favor, tho. He doesn't want to have a two for one sale.

My advice if this doctor insists that this is the way it has to be,,, is to look for another doctor. None of the ones I go to would try this,,,, not more than once, that is.
ed

[lonebobseytwin]

ive had doctors do that before and I don't even have medicare yet.

ortho's get weird sometimes, and if your there for only one thing they won't look at anything else.
They tend to classify things as an individual problem and don't tend to see correlations to things.
If it's not a broken bone or a ligiment they don't seem to care.

[A trophy guy]

lonebobseytwin, on 26 January 2012 - 06:46 AM, said:

They tend to classify things as an individual problem and don't tend to see correlations to things.

This is actually one of my biggest complaints/issues with doctors in general; especially in relation to my spinal-cord injury.

[Tim13]

Perhaps this question could best be answered by the people who made the (sometimes confusing) rules in the first place:

Visit Medicare.gov, or call 1-800-MEDICARE.

[dreamerr]

You are more likely to have this issue if you go to a group of doctors. I go to a private doctor and he spends about a half hour with me to do nothing. We chat he gets updated and that is it. He never ever rushes me. I hate doctors that are part of groups cause they are more like meat markets. It is very hard to find private ones now but look and you might. I spent a year looking for one when I moved to this state.

Stand117711 with both medicare and my old insurance almost nothing is covered as far as equipment. I do think it may depend on what is in your records and how much fighting you want to do. There are ways to get stuff if you don't mind waiting forever and jumping through hoops on the way there.