Stat Medical Billing Service

Let me tell you why I love my job. I just got off the phone with a guy who broke both legs. He is a young guy, a victim of the s*x trade. He is trying so hard to pull his life together. He is the same age as my own son. He makes too much money to qualify for AFA plans. He works full time with no benefits. And, he is in school full time. He can't afford private insurance. He was looking for a doctor that would cut him some slack with his treatment. He probably needs surgery. There is no way he could pay out of pocket if he does need surgery. I told him I was not going to let him off the phone until I could figure out how to help him. Then, it dawned on me. He's a full time student and universities require students to opt in to the student health plan unless they can prove they have insurance. I told this guy it's part of the tuition and fees you pay. Scholarship or not. So, he's checking to see about his student insurance and he will probably get all the treatment he needs. This is why I love my job. I love to help people and I love to help my providers have successful practices.

Every medical practice front desk person needs to be sure to check eligibility including Medicare patients. There are more and more of these Medicare advantage plans coming out all the time. I refer to them as Medicare disadvantage plans. It seems to me that the only one with an advantage in this situation is the insurance company, certainly not the patient and definitely not the doctor. People get onto these plans because some of them have a zero dollar premium. Well in healthcare, as the rest of life, you get what you pay for. I had a patient on the phone who told me he was dying of cancer because the Medicare advantage plan he got on did not have any available oncologists that would accept his insurance. This man worked his entire life, paid into Social Security, is entitled to Medicare and I believe he died recently directly as a result of this greedy insurance company. Now granted I may not have the whole story on this.

The point of this post is that many patients try to tell me that if their Medicare advantage plan doesn't pay then go ahead and bill Medicare. And patients need to understand that that is not a possibility. Your front desk person should basically explain it to them like this: you sold your Medicare rights to this insurance company. All of your Medicare benefits go through this Medicare advantage plan now.

My strong suggestion to your front desk employees is two or three days before the appointment or better when they make the appointment, check on the Medicare portal to see if they are on a Medicare HMO. It takes only about 30 seconds to check eligibility online and it's very easy. Feel free to contact me if you need help getting this set up. It will save a lot of time and aggravation and save you a lot of money.