When Will Medicare Let Me Know If They Will Cover My Treatment?
Want to make sure that Medicare will cover your treatment. Check with the business office and
ask them if the treatment is a Medicare covered procedure. Usually the business office is very knowledgeable and can answer that question for you. Or if you prefer you can call Medicare and ask to speak with someone in claims. Say you would like to verify if the treatment is a covered procedure. In either situation you will at that time find out if Medicare will cover the treatment received. One question that they will probably ask is what symptoms you have to receive this treatment or if you know the diagnosis.
Have plenty of money? If you decide you don't want to do either of the previously mentioned suggestions,
then it should take approximately 45 days to find out if Medicare covered your treatment. You will receive a form from Medicare that is referred to as an EOB, (Explanation of Medicare Benefits) that will show you if they
covered your treatment. If the treatment is not covered you can go back to the Dr.'s office and ask them if they would appeal your claim. Normally most offices will appeal to Medicare or other insurance. When you get the EOB from Medicare it will show what the charge is, what insurance will pay. The difference between the two must be written off or taken off your account.
Usually the Dr.'s office or facility will do as much as they possibly can to get the treatment covered. Most
understand that it is easier for them to appeal a decision then to ask you to appeal to Medicare. If you are willing to do a little more work in the beginning it will be much less work and possibly cost in the end.