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Social Security & Medicare

Susan Calvin

(2,322 posts) Fri Nov 29, 2019, 05:17 PM Nov 2019

I just got an ABN from the blood test lab, and I am very confused. [View all]

It was a form that said they didn't expect Medicare to pay for some or all of the tests, and they wanted me to sign it saying I'd pay if Medicare didn't.

I don't know if it was all or some at this point actually, because they wouldn't give me a copy of it and I said well I'm not going to pay for it if I can help it so I'm gonna check into this.

Checking into it did not go well.

I called the doctor's office and they basically said they couldn't help me understand what was going on. At all.

Then I called Medicare. They said they couldn't help either. Even though I gave them the names of the tests and the codes. Which I really found nuts, because when they get bills, I'm quite sure they figure out whether they will pay for them or not.

24 replies

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I just got an ABN from the blood test lab, and I am very confused. [View all] Susan Calvin Nov 2019 OP

That unquestionably sucks, but you are stuck with a Hobson's choice... TreasonousBastard Nov 2019 #1

I just went through the same thing BittyJenkins Nov 2019 #2

sounds like the doctor's office may have used an incorrect diagnosis or code on the written order yellowdogintexas Nov 2019 #6

Pretty sure it comes down to the code in my case. Susan Calvin Nov 2019 #11

Did you get the test???? dixiegrrrrl Dec 2019 #22

Thank you for asking. Susan Calvin Dec 2019 #23

Medicare pays for 80% of what is deemed "reasonable" CharleyDog Nov 2019 #3

Except Medicare providers are required to accept the amount Medicare says is reasonable - pnwmom Nov 2019 #4

not exactly how payment is determined yellowdogintexas Nov 2019 #5

The lab I went to did not even contact the doctor's office. Susan Calvin Nov 2019 #12

Susan it may have been some or all of the charges. yellowdogintexas Nov 2019 #7

I'm on traditional Medicare and TRICARE. Susan Calvin Nov 2019 #13

Medicare isn't shy about stating that if a provider won't cover the cost of a procedure then the abqtommy Nov 2019 #8

Wow, it sounds like you talked to some people at Medicare who are actually competent. Susan Calvin Nov 2019 #16

From my experience that is standard, if Medicare or any insurance for that matter doesn't cover still_one Nov 2019 #9

I'm not sure now, since they wouldn't give me a copy of the ABN, Susan Calvin Nov 2019 #14

I think your assessment is probably right. Regardless, if you need the results in orders to know still_one Nov 2019 #15

Thank you so much for the responses. Susan Calvin Nov 2019 #10

That is absolutely standard. PoindexterOglethorpe Nov 2019 #17

Actually, they had the cost right on the form they wanted me to sign. Susan Calvin Nov 2019 #18

Oh, good, I'm glad they had the cost. PoindexterOglethorpe Nov 2019 #19

You're probably right about the Medicare website, but I have had no luck so far . Susan Calvin Nov 2019 #20

Trust me, there is zero transparency about the cost of anything PoindexterOglethorpe Dec 2019 #21

That's for sure El Mimbreno Dec 2019 #24