| Subject | Date Asked | Expert |
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| Medicaid not paying | 10/20/2008 | Tricia |
Q: I went to the emergency room and was not asked about insurance while there. I received a bill over a ...
A: Usually you can appeal a denial. Call Medicaid and ask how you can appeal the denial. Also ask ...
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| Medicare Part A & B | 10/20/2008 | Kyla Kelim |
Q: I receive FREE VA medical care, except dental. Can I get my teeth worked on with Medicare? I need ...
A: Medicare does not cover dental services , however, you might have a Medicare managed care plan that ...
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| is my medicade active? | 10/19/2008 | Tricia |
Q: i called the the # 800-997-1111 but i dont know what to do through all the prompts i just want to ...
A: Dana! Each state has it's own number and I have no clue what state you live in.....go to the ...
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| Medicare, medicaid,share cost | 10/18/2008 | Kyla Kelim |
Q: i am turning 65 at the end of this year and might need supplemental insurance but i am very confused ...
A: You are in luck with this. As complex as this area of health care has become, the government has ...
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| is my medicade active? | 10/18/2008 | Tricia |
Q: i called the the # 800-997-1111 but i dont know what to do through all the prompts i just want to ...
A: Don't know all the Medicaid phone numbers since each state is different....but if that is your ...
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| Medicare C | 10/18/2008 | Merry Schiff |
Q: My mother lives in Atlanta Ga. someone continues to call her re: the above. I am unclear as to why ...
A: The sales people are NOT allowed to solicit. She does not need an HMO. Actually if she is happy with ...
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| medicaid | 10/18/2008 | Merry Schiff |
Q: can a doctor refuse to re-bill medicaid (in North Carolina)because you have not received your card ...
A: Here is the story. Did your doctor take you as a Medicaid patient when he or she saw you for ...
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| cost coverage | 10/17/2008 | Tricia |
Q: I am 42 years old and weight around 260. I've tried everything to lose weight. I have tendentious in ...
A: Since you probably make to much money for any type of Medicaid, perhaps call some clinics that ...
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| HMO out of state | 10/16/2008 | Tricia |
Q: I have coverage with an HMO in Hawaii and am currently in North Carolina, where I have delivered a ...
A: I think I would be careful of bringing up that there was a provider within 15 miles...if you were ...
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| Medicare Primary - Medicaid QMB | 10/15/2008 | John Pedit |
Q: If a patient has Medicare Primary and has applied for Medicaid - can they sign up to a Medicaid HMO, ...
A: Usually you will end up with Medicare and Medicaid which makes you a dual eligible. Along with that ...
|
| Helping My Father Change from Sr. Dimensions to Medicare in Nevada | 10/15/2008 | Merry Schiff |
Q: My father is 81 years old and would like to switch from Sr. Dimensions to traditional Medicare. We ...
A: Great news Christine..Your dad can switch once during the Annual Coordinated Election Period which ...
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| Transfering medicaid from one nursing home to another in another state | 10/15/2008 | Merry Schiff |
Q: The nursing home my relative is presentlt in(3 yrs.)is being closed by state of Mich.They are in ...
A: You may very well have a residency problem. You are smart that you are questioning this. If you will ...
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| copayment | 10/15/2008 | Tricia |
Q: What is the copay amount for a doctors office call if I am on Medicare? Thank you
A: Your copay amount depends on what the Dr charges. You are liable for 20% of the approved amount by ...
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| medicare and infertility | 10/15/2008 | Kyla Kelim |
Q: and I been fighting infertility for about 10 years now. And I only have Medicare part A and B. I am ...
A: Peggy, sadly, no. There are very few insurance plans that will cover infertility treatments in the ...
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| changing medicare to primary and suppliment to secondary | 10/15/2008 | John Pedit |
Q: I have a family member who's secondary insurace is Medicare and primary insurance is Advantra GHP- ...
A: This appears to be a situation where the family member is on a working spouse or their own ...
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| More than one treatment rendered in same day | 10/14/2008 | Tricia |
Q: I've got another exciting one for you! Patient is treated by chiropractor twice in one day. I ...
A: You have a few options and most are based on what insurance company you are billing since all have ...
|
| HMO out of state | 10/14/2008 | Tricia |
Q: I have coverage with an HMO in Hawaii and am currently in North Carolina, where I have delivered a ...
A: I think your best bet is to appeal with medical info from your NC Dr stating that you had ...
|
| Insurance won't pay for MRI | 10/14/2008 | Tricia |
Q: My sister was recently diagnosed with a brain anuerism, her attending physican (Director of ...
A: You need to prove to them it is just not a screening. Perhaps get a good strong detailed letter of ...
|
| Denied Claim | 10/14/2008 | Tricia |
Q: My daughter's insurance company is denying payment for surgery that was preauthorized before the ...
A: I would get a copy of the preauthorization from the Dr's office and send an appeal to the insurance ...
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| Mayo Clinic, Scottsdale & out-of-state medicaid | 10/13/2008 | Kyla Kelim |
Q: My sister is on her way to this clinic, with a referal from her Dr. in New Mexico. She has severe ...
A: Thea, not everyone accepts Medicaid, unfortunately. Some insurance companies are coming up with ...
|
| claim appeal | 10/13/2008 | Tricia |
Q: I have a question, an employee of ours finally got our insurance company to cover a claim from last ...
A: A provider does not have to wait until a patient appeals with their insurance company. On the first ...
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| ER Billing | 10/13/2008 | Tricia |
Q: I went to the ER to receive 13 sutures in my left leg. I do not have Med. insurance. I paid the ...
A: Call the hospital up and ask them directly. Usually they can not double bill for same code for the ...
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| Does Kaiser have an obligation to provide an expert surgeon? | 10/13/2008 | Merry Schiff |
Q: My daughter has to have arthroscopic hip surgery to repair FAI. She is only 12. This is an ...
A: Interesting question. I am in CA also so I am familiar with Kaiser. I would talk to someone at ...
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| coverage for spouse | 10/12/2008 | John Pedit |
Q: I am employed at a hospital and I provide hospitalization for both my husband and myself. He will ...
A: If he is already drawing social security, he should receive his Medicare card somewhere around May ...
|
| do I need medicare part B | 10/12/2008 | Kyla Kelim |
Q: I am retired and live in Florida. I have Blue Cross Blue Shield Federal Basic plan. Do I need ...
A: Jim, it depends. This is a very good, but very case specific question. Please contact your local ...
|
| do I need medicare part B | 10/12/2008 | John Pedit |
Q: I am retired and have Blue Cross Blue Shield Federal Basic plan insurance. Do I need medicare part ...
A: If you are retired and 65, Medicare becomes the primary insurance. So you will need Part B, ...
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| My Sister's Disability | 10/11/2008 | Kyla Kelim |
Q: Good morning Kyla! My sister has MD. She reccently moved back to Ohio from North Carolina where she ...
A: Joyce, just from the information you're giving me, I don't know. I believe that its each month she ...
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| Weight loss surgery | 10/10/2008 | Tricia |
Q: I am a 25 year old female and I weigh 274 pounds. I have done a complete life change over the last ...
A: I think they will if you meet their guidelines.......you may have a problem finding a Dr local ...
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| moving from OH to CA Medicare HMO Coverage | 10/10/2008 | Merry Schiff |
Q: My father recently had a stroke (1 month ago) and is currently in a short term stay in Skill Nursing ...
A: You need to contact AARP and see if they have coverage in the area that your father will be moving ...
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| medicare secondary insurance | 10/8/2008 | Merry Schiff |
Q: I have medicare in Texas thru Trailblazer as my seoncdary insurance. I am trying to find out if ...
A: no..Medicare will pay up to their allowables on each procedure. Does your primary insurance pay 85% ...
|
| Dental Insurance | 10/8/2008 | Tricia |
Q: I live in California and have dual Dental Insurance Coverage due bad teeth. Dental work was ...
A: Yes insurance companies all have time limits to submit billing however if the reason is a good one ...
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| out of network billing for emergency surgery | 10/8/2008 | Merry Schiff |
Q: My boyfriend was in a motorcycle accident, was taken to UCI Med center with a broken back. Surgery ...
A: Kaiser will have to pay. The physician who treated him has to document that he could not be ...
|
| out of network surgery/ kaiser refuses to pay | 10/8/2008 | John Pedit |
Q: My boyfriend was in a motorcycle accident, was taken to UCI Med center with a broken back. Surgery ...
A: There is a missing factor here. Did he have any kind of accident insurance. If so, then the ...
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| Insurer Denies Payment for Physical Therapy | 10/8/2008 | Tricia |
Q: My wife had been receiving physical therapy for several months which was being paid for by our ...
A: Yes an insurance company can deny claims after someone receives the treatment even if the Dr feels ...
|
| coordination between medicare & medicaid | 10/7/2008 | Merry Schiff |
Q: My father in law is currently enrolled in a ppo plan and is also on medicaid. He is in a nursing ...
A: I FIL is in a Medicare Advantage Program. If you go to Original Medicare, you have a choice of ...
|
| Cobra and Medicare | 10/7/2008 | Kyla Kelim |
Q: My fiance is 67. He turned down Medicare because he was employed & covered by his employers ...
A: Barbara: this is on Social Security's website:What happens if I am in Medicare and choose to get ...
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| EDICARE BILLING | 10/6/2008 | Tricia |
Q: How do i get a copy of medicare payments to my doctors
A: Every time Medicare makes a payment for you they should send you an EOB, explanation of benefits ...
|
| OVERPAYMENT ON PRISCRIPTIONS | 10/6/2008 | John Pedit |
Q: I PAID FOR RX,S BECAUSE THE PHARMACIST TOLD ME HE COULDN'T GET THEM TO GO THROUGH THE COMPUTER I WAS ...
A: You need to sit down with the SHIP counselor from your area. They are trained by CMS to assist with ...
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| Medicare and Tricare | 10/3/2008 | John Pedit |
Q: John, I was medically retired from the military in March 2003. I was eligible for Tricare Prime ...
A: Makes no sense to me, The important date is the date SS picks to make you eligible for SS ...
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| Amerigroup Medicaid | 10/3/2008 | Tricia |
Q: I have 2 stepsons whose mother is court ordered to cover them on insurance. She has them on ...
A: No the mother can not just switch over to another insurance company since usually the employer is ...
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