Spoke with Geri at Dr office today

May 29, 2009

Spoke with Geri at Dr Marema's office today, I may not be able to use them for my surgery, so I am really disappointed.  I don't know what to do.  She states that Flagler hospital has decided to treat people with Medicare who are seeking revisions as the same as self-pay.  Apparently they haven't been being reimbursed by Medicare for the revisions for the past year, so most likely I will either have to pay them 31,000 dollars up front, or choose another provider.  Geri states she doesn't really know why this is occuring so her office manager is going to speak with the hospital person who made this decision and see if anything can be done.

I called and spoke with the Medicare people and they gave me the same guidelines that Dr. Marema's office had given me in February, and I have met all these guidelines and it is a covered benefit.  He doesn't know why the hospital is not being reimbursed by Medicare and suggested it may simply be a coding error on the hospital's fault.

After I spoke with Medicare people I called Geri back and told her the results of my conversation with Medicare in hopes that maybe that would help the office manager ask the hospital to get on the phone and call Medicare and find out why they are not being reimbursed when this is a covered benefit.

I don't know what to do.  I like Dr Marema's and his office staff and the only other place I found that does revisions and accepts Medicare is in Miami and that is 4-5 hours away, Dr Marema is only 2, but I need this surgery and may have to go that route.   Geri said she will call me back next week, so maybe I'll just wait until she calls me back and then go from there.

I'm trying not to give up, but it is so discouraging.

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