I'm looking for input from post-op DS patients of Dr. Houston who are on Medicare. I'm trying to find out how much I'm looking at total for copays (including surgery) to Dr. Houston's office. The hospital files QMB, which covers all of my deductible and copays, but Dr. Houston's office does not. From first post-op through your initial one week follow-up, can you tell me how much you paid to his office?
After doing some research, I've found that most provider's offices are grossly misinformed regarding the QMB (Qualified Medicare Beneficiary) program, which is a cost-sharing program administered by Medicaid. A facitily does not have to accept Medicaid to file for payment of copays from the QMB program. I'm sincerely hoping for some advocacy and education of clinics soon to make this program more functional. My own PCP doesn't even file QMB, but they still take QMB clients and just write off the copay. It's a waste, because they could actually be collecting that if they understood it. Centennial is the first place I've encountered that knows what it is and accepts it. My hands feel tied at the moment, because I want to push this topic with providers, but I don't want to do it at risk to myself not being have this surgery. Dr. Houston is my third doctor choice because I've been fighting several different battles just to find a surgeon. Thankfully, knowing what I know now, Dr. Houston is also my first choice and I'd pick him over the others if I was just starting the process.