Q: When a huge company fires you as CEO for overseeing a $2 billion fraud, what do you do?
A: You run for the US Senate — and win.
Is America a great country, or what?!
(p.s. ...Not quite great enough to give 330+ million people basic healthcare as a right — while saving trillions of dollars per decade and a quarter million lives. But that's another story. )
RJ Barnabus charges $602 for a dr to give test results in a 3 minute phone call? Since when does one pay for test results from a bone scan? When I go for base line results doesn’t my copay entitle me to my results? My mammogram test sent me a letter… no extra charge… my on gyn charged me $10 while charging taxpayers $602 ( Medicare) when I called for results of a bone scan I never received. Fraud?
It sounds like it. If you have Medicare(traditional) you might want to pass it on to them, after calling the Dr's office and complaining. It sure sounds fishy.
This is an eye opener. Medicare Advantage is responsible for so much more fraud than Medicare!
Here are other SNAFUs that make traditional Medicare ineffective. Providers (and I was one who accepted Medicare) often opt out of Medicare because it underpays compared to some Medicare Advantage plans. And while private insurers allow providers to enter their full background information in portals accessed by many companies, Medicare has its own application and renewal process that is many pages long and takes forever to bring the provider into the network. It's no joke, they want your entire academic and professional history, even if that goes back many years and you hold a current license to practice. Digging up that information is painful, especially since some of the training sites are no longer in operation to provide copies of information. Meanwhile, there aren't enough providers who could be treating patients but for such administrative gauntlets.
I would guess that Medicare, like so many other government programs, is underfunded so the portal and application process can't be updated from the legacy system. And, they can't have enough reviewers of provider applications to on-board them quickly. Conservative opponents of "big government" underfund it so it will fail and then blame the government for the flaws they keep in place. Sound familiar? (Here's looking at you Speaker Johnson.)
When I was last involved with Medicare, it took six months to get into the network. I had to submit a routine change of office address because the rules dictated that I couldn't accept Medicare for my ongoing patients without being authorized at the new address. I was told that it would take months. You would think a registered provider could just login and update the information themselves. But no. It's a clumsy legacy system that must run on old mainframe computers.
I fast-tracked that address with the help of a staffer for my then Member of Congress, Jaime Herrera Beutler. When I spoke with a Medicare representative to complete the last bits of the address change she was angry at me because I had jumped the queue, something I'd done to provide continuity of care while accepting below market fees.
Q: When a huge company fires you as CEO for overseeing a $2 billion fraud, what do you do?
A: You run for the US Senate — and win.
Is America a great country, or what?!
(p.s. ...Not quite great enough to give 330+ million people basic healthcare as a right — while saving trillions of dollars per decade and a quarter million lives. But that's another story. )
Well said. Ira.
RJ Barnabus charges $602 for a dr to give test results in a 3 minute phone call? Since when does one pay for test results from a bone scan? When I go for base line results doesn’t my copay entitle me to my results? My mammogram test sent me a letter… no extra charge… my on gyn charged me $10 while charging taxpayers $602 ( Medicare) when I called for results of a bone scan I never received. Fraud?
It sounds like it. If you have Medicare(traditional) you might want to pass it on to them, after calling the Dr's office and complaining. It sure sounds fishy.
Writing to the CEO!
Alan,
This is an eye opener. Medicare Advantage is responsible for so much more fraud than Medicare!
Here are other SNAFUs that make traditional Medicare ineffective. Providers (and I was one who accepted Medicare) often opt out of Medicare because it underpays compared to some Medicare Advantage plans. And while private insurers allow providers to enter their full background information in portals accessed by many companies, Medicare has its own application and renewal process that is many pages long and takes forever to bring the provider into the network. It's no joke, they want your entire academic and professional history, even if that goes back many years and you hold a current license to practice. Digging up that information is painful, especially since some of the training sites are no longer in operation to provide copies of information. Meanwhile, there aren't enough providers who could be treating patients but for such administrative gauntlets.
I would guess that Medicare, like so many other government programs, is underfunded so the portal and application process can't be updated from the legacy system. And, they can't have enough reviewers of provider applications to on-board them quickly. Conservative opponents of "big government" underfund it so it will fail and then blame the government for the flaws they keep in place. Sound familiar? (Here's looking at you Speaker Johnson.)
When I was last involved with Medicare, it took six months to get into the network. I had to submit a routine change of office address because the rules dictated that I couldn't accept Medicare for my ongoing patients without being authorized at the new address. I was told that it would take months. You would think a registered provider could just login and update the information themselves. But no. It's a clumsy legacy system that must run on old mainframe computers.
I fast-tracked that address with the help of a staffer for my then Member of Congress, Jaime Herrera Beutler. When I spoke with a Medicare representative to complete the last bits of the address change she was angry at me because I had jumped the queue, something I'd done to provide continuity of care while accepting below market fees.