my take on it...
Posted By: JK on 2006-04-30
In Reply to: Question about Medicare. - Spice
If this was the first hospitalization of the year or she hasn't met her deductible it is possible it went towards her deductible. If that's the case, the Nephrologist probably did get their bill in first. However, it should say right on the EOB if there was an amount applied towards the deductible. If the deductible has been met prior to this, then there was a problem. Yes, it sounds like a call to Medicare is warranted. If you wanted to call the Nephrology office first just because they might be easier to reach, they will have the EOB there too and might be able to answer your question. Chances are very good they've already seen the EOB and evaluated it. It could be a wrong CPT code or not enough documentation on their part to warrant the charge. Either way that doesn't sound right! If you can't get any help that way I'd made that dreaded call to Medicare and see if they can explain everything. It could be any number of things but I think you're doing the right thing by doing some followup!
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