Mayo Clinic

[potsgirl]

An insurance update for ALL Mayo Clinics....They DO accept Medicare just like they used to. The insurance department told me that a rumor started about 8 months ago that they no longer accepted Medicare, but it is NOT true. I'm off to an appointment there today, but wanted to spread the word.

Hope this clarifies the situation!

Cheers,

Jana

[comfortzone]

What I learned recently is that yes they do bill Medicare for you. When you get your bill by law they are allowed to charge up to 15% more than what Medicare will pay so you may end up with out of pocket costs. So they don't accept 'Medicare Assignment' or the amount Medicare pays as 'enough money'.

Also if you are to go to a primary care doctor - they flat out do not accept you as a new patient if you have Medicare as your insurance. However....if you have good private insurance initially -- but then switch to Medicare -- they will keep you as a patient I was told. It seems that for routine primary care you cannot see a Mayo doctor with Medicare as your insurance - unless you self pay perhaps.

Not wanting to confuse things - just that I spoke with them very recently and this was what I was taught by the billing office. Good luck at your appointment(s) today!

[ken870]

i have medicare and i am still waiting to see a autonomic specialist there and it has been seven months do you think they will accept my medicare because i need to see a doctor soon they told me to have my doctors called them and my cardiologist did two weeks ago but still no call with an appointment so i am trying now to get my neurologist to call and see what they can do if they are getting people first with severe problems i would hate to see them because my records told them i had severe autonomic neuropathy and pots which has me bedridden and in a wheelchair when i do go anywhere.

[McBlonde]

Wow, I had no idea this was an issue with Mayo!

It's very important to know which post is correct....1 or 2.

If Mayo has not signed a contract with Medicare to accept assignment, then that is a everyday example of rationing of healthcare to the more affluent.

If Mayo has NOT signed a contract to with Medicare, then the bill could work like this example:

Before I posted, I verified with Mayo that they DO NO ACCEPT MEDICARE ASSIGNMENT:

From Mayo:

When claims are sent to Medicare on a non-assigned basis, the benefits for the services are sent directly to the patient. Mayo Clinic is entitled to bill the patient for the difference between our billed amount and Medicare's approved amount. We do not have to accept Medicare's approved amount as payment in full.

So if your bill is $50,000 and Medicare's normal payment to contracted providers is $5000, then you are responsible for $45,000.

If you have supplemental insurance, you should check with them. Some will pay what Medicare doesn't but just as many will only pay the 20% of the Medicare allowable.

This is a trend I saw starting in CA about 7 years ago with many of the sub-specialist no longing accepting ANY insurance payments. My neuro-endocrinologist is cash up front. Scary isn' it.

[Poohbear]

Medicare does not accept medicare assignment; they will file claims for you and there are a few exceptions but you, as a patient, are generally responsible for the full amount of the bill regardless of what Medicare pays or allows.

Mayo clinic clearly states this on their website.

[McBlonde]

Medicare does not accept medicare assignment; they will file claims for you and there are a few exceptions but you, as a patient, are generally responsible for the full amount of the bill regardless of what Medicare pays or allows.

Mayo clinic clearly states this on their website.

Poohbear, we are in real trouble when Medicare doesn't accept Medicare assignment!

LOL, that's the way my brain works now, too, (make that.. doesn't work). What can we do but laugh.

Seriously, though, I went to their website and saw what you are saying. Also when I Googled Mayo Medicare, there were some interesting local newspaper articles responding to the Jacksonville clinic's "business" decision.

[comfortzone]

i have medicare and i am still waiting to see a autonomic specialist there and it has been seven months do you think they will accept my medicare because i need to see a doctor soon they told me to have my doctors called them and my cardiologist did two weeks ago but still no call with an appointment so i am trying now to get my neurologist to call and see what they can do if they are getting people first with severe problems i would hate to see them because my records told them i had severe autonomic neuropathy and pots which has me bedridden and in a wheelchair when i do go anywhere.

Hi

I was under the impression through my own very recent experience that you do not NEED a referral to go to the Scottsdale AZ Mayo Clinic offices. True, I used private insurance -- But because I was insured -- and Mayo is a 'preferred provider' for my insurance .... I absolutely did not need a referral. I called the

Schedulers....and they made the appointment. Every so many weeks the calendar opens up for any particular doctor and they fill it up with waiting patients. You can ask the secretary to give you a call as soon as the next months schedule opens up.....so you can book your appointment.

I guess I assumed you didn't need a referral for Medicare either - when you see a specialist. But here's where I may be wrong.....if they told you you HAD to have a referral ... well you do have one from what you wrote. So now it's a matter of asking them in direct and pointed language -- which month are they scheduling for now..... and then WHEN does the schedule open back up again for -- which next month..... Tell them in no uncertain terms that you will call daily if you must -- to get on a list for cancellations or to at least be scheduled NOW - even if it's a far out appt.

Another tactic would be to try and see a totally different specialty in Mayo where you are sure you need care as well - that has a shorter waiting list....say cardiology or whatever else ails you.....then once you are in the doctors office at your appointment --- that doctor's job is to plug you into all the doctors you need to see in a timely fashion. Yes sometimes this means you wait 'on-call' in a waiting room for the chance to be squeezed in suddenly -- but it's a great system in the end -- I saw 4 busy doctors inside of 2 weeks and had numerous tests. So is there by chance a related specialty you might benefit in seeing there -- ?? Just to get yourself in? I'm only brainstorming here trying to think outside the box....cuz I wish you didn't have to wait so long!!!

Blessings!

[comfortzone]

Wow, I had no idea this was an issue with Mayo!

It's very important to know which post is correct....1 or 2.

If Mayo has not signed a contract with Medicare to accept assignment, then that is a everyday example of rationing of healthcare to the more affluent.

If Mayo has NOT signed a contract to with Medicare, then the bill could work like this example:

Before I posted, I verified with Mayo that they DO NO ACCEPT MEDICARE ASSIGNMENT:

From Mayo:

When claims are sent to Medicare on a non-assigned basis, the benefits for the services are sent directly to the patient. Mayo Clinic is entitled to bill the patient for the difference between our billed amount and Medicare's approved amount. We do not have to accept Medicare's approved amount as payment in full.

So if your bill is $50,000 and Medicare's normal payment to contracted providers is $5000, then you are responsible for $45,000.

If you have supplemental insurance, you should check with them. Some will pay what Medicare doesn't but just as many will only pay the 20% of the Medicare allowable.

This is a trend I saw starting in CA about 7 years ago with many of the sub-specialist no longing accepting ANY insurance payments. My neuro-endocrinologist is cash up front. Scary isn' it.

I'm pretty sure that the law states that no provider is allowed to charge anymore than 15% above what Medicare pays out. So you can still utilize Mayo's specialists -- an example on the website was to have a bill where you had to pay your 20% copay (or maybe not if you have good Gap insurance coverage for Medicare) -- but over and above that Mayo can charge for something 15% higher.....and you must pay that. So yes to use their services with Medicare you can plan on paying your co-pay and additionally they can sting you for 15% more .... More and more doctors where I live do not accept Medicare assignment as they don't feel it's fair to get paid so little. There was even a 'whiney' letter posted all throughout a large cardiology practice about people needing to excuse them if they seem stressed!!!!! That all this Medicare nonesense meant they were overwhelmed....but not to worry they truly did care about us....as they discuss not taking Medicare assignment for payment. People are having heart attacks and I'm to worry about the doctors bank account????

I thought I was going to get sick right there on the spot. What a bunch of unprofessional cry babies.

[potsgirl]

Example to clarify.....Wow, I guess I created a real mess here. All of the Mayo Clinics, including Jacksonville, accepts Medicare. They are not contracted with Medicare, but will file for you. By not contracting with Medicare, it means that Mayo does not accept the allowable amount that Medicare pays for any service. They can charge up to 15% more for the procedure for which Medicare deems allowable, and you need to pay the usual difference (usually 20%) plus that extra 15% fee. It also makes a difference if you have additional, or supplemental insurance with your Medicare plan. I do not. So, for me, the scenario would be this:

Fee: $115 (the 15% extra Medicare charges from what Medicare deems allowable)

Medicare allowance for this service: $100

Medicare pays 80% of $100: $80

YOU PAY: $20 (difference between Medicare's $80 to the $100 allowable) PLUS the extra $15.00 Mayo is allowed to charge above and beyond...

SO, in my case, I would end of paying $35.00 for a service that cost $115.00 initially. To extrapolate, on a $1,150 bill, I would eventually pay $350. Not great, but I think it's worth the extra cost if you have a good doc there. If you have supplemental insurance, it would probably cover the 20% difference (in my example) so you would end up only paying the 15% additional fee between Medicare's allowance and Mayo's fee.

Please note: I got this example and information directly from Mayo Clinic's website. I went to Scottsdale's page, typed in 'insurance', clicked on that, and then clicked on 'Medicare'. It explains this all in detail. If in doubt, call their billing office, but this is how it's always worked for me.

Hope this helps clarify things!

Cheers.

[potsgirl]

Ken,

Your situation really baffles me. I know that at the Scottsdale location they're scheduling at the end of October, beginning of November. Are you willing to travel? I don't know where you live....I called last Thursday, they had a cancellation for Monday, and I just had a consult yesterday afternoon. Try Dr. Goodman at the Mayo Clinic in Scottsdale, AZ. Do you need a referral? Dr. G is a neurologist, but also specializes in POTS/autonomic dysfunction and is great!

[ken870]

Ken,

Your situation really baffles me. I know that at the Scottsdale location they're scheduling at the end of October, beginning of November. Are you willing to travel? I don't know where you live....I called last Thursday, they had a cancellation for Monday, and I just had a consult yesterday afternoon. Try Dr. Goodman at the Mayo Clinic in Scottsdale, AZ. Do you need a referral? Dr. G is a neurologist, but also specializes in POTS/autonomic dysfunction and is great!

i found out what the problem is my doctors recepionist told me that mayo sent them a letter stating they did not want to see me so i called mayo and they told me she was lying that i was still on the waiting list and if my doctor would call them i could be seen sooner so i believe my doctors recepionist is mad at me for some reason and told my doctor lies about me and when i told mayo this they were mad and wanted my doctors phone number to call tostraighten everything out so when they call and hopefully speak to my doctor i will be headed to mayo.

[comfortzone]

Ken,

Your situation really baffles me. I know that at the Scottsdale location they're scheduling at the end of October, beginning of November. Are you willing to travel? I don't know where you live....I called last Thursday, they had a cancellation for Monday, and I just had a consult yesterday afternoon. Try Dr. Goodman at the Mayo Clinic in Scottsdale, AZ. Do you need a referral? Dr. G is a neurologist, but also specializes in POTS/autonomic dysfunction and is great!

i found out what the problem is my doctors recepionist told me that mayo sent them a letter stating they did not want to see me so i called mayo and they told me she was lying that i was still on the waiting list and if my doctor would call them i could be seen sooner so i believe my doctors recepionist is mad at me for some reason and told my doctor lies about me and when i told mayo this they were mad and wanted my doctors phone number to call tostraighten everything out so when they call and hopefully speak to my doctor i will be headed to mayo.

Finally Ken........Yipppeeeeeeeeeee!!! While it's really terrible all you've been through to get to this point -- at least now you are fully moving forward -- GREAT NEWS! :-) Keep on smiling Ken! You persevered and resolution is forthcoming ... good for you!

[potsgirl]

Ken,

Wow! What a weird mess. I'm glad you found out what the problem was, and I hope they discipline that receptionist! Yay, though, that it sounds like you're finally going to make progress and get in. Dealing with doctors is absolutely exhausting sometimes. Kudos to you for sticking with it, and please let us know what you find out. Which Mayo are you headed for?

Cheers,

Jana

[ken870]

Ken,

Wow! What a weird mess. I'm glad you found out what the problem was, and I hope they discipline that receptionist! Yay, though, that it sounds like you're finally going to make progress and get in. Dealing with doctors is absolutely exhausting sometimes. Kudos to you for sticking with it, and please let us know what you find out. Which Mayo are you headed for?

Cheers,

Jana

Jana i am going to the mayo clinic in rochester minnesota when they call me also does anybody know if the flooding in minnesota has affected the mayo clinic.

[potsgirl]

Hi Ken~

No, I think the Rochester Clinic is fine. Remember, they have hotels and a 'subway' system underneath the ground from 2-3 hotels that go to the main Mayo Building, where your initial appointment will probably be. When I was there in March, it was a terrific help - it was so cold outside. Those hotels are more expensive than what you'd pay if you stay further away and drive in, though. The hotels were the Kahler Inn & Suites and the Marriott. The Marriott gets cheaper the longer you stay. You can always book a week and then cancel if you don't need to be there that long. I stayed about 10 days, since we had to stay over the weekend. Parking is free, and inside. Breakfast is also free.

If you're going with someone, and I hope you are, I would recommend either hotel, although if money isn't an object, I'd go to the Marriott. Very nice.

Please PM me if you'd like more information.

Cheers,

Jana