Medicare Fraud? What do you think? Greed? Uncaring? 3 payments, one appt.

I’m tired so this is cut to the chase.  The past year has worn me out. A  broken femur followed a few months later by getting thrashed and trashed by a reckless driver.  He was found 100% responsible for the accident and total loss of my Prius.   However, months later here I am still looking for help for the damage he caused me. Competent help.  What I learned by hiring a personal injury attorney is : this is a racket.

First,  a caveat.  A thank you to  Dr Botts, ortho surgeon who put in a titanium rod  for broken femur..here’s the post I wrote for him last year: https://www.annbradley.com/a-song-of-gratitude-for-dr-botts/

 

Credit where credit is due. Credit too for my Apple watch and its crash reporting ability. It got the paramedics to me within about 3 minutes of the crash and notices to my contacts of the crash, the paramedics got me to the ER soon thereafter. Thank you Tim.

 

Current issue: low back pain and search for help – some crash medical issues have resolved (e.g. cracked sternum) others show up over time due to spinal issues and concussion.  I want to walk normally, and go dancing.  I’ll choose a doctor this time, not a personal injury attorney.  This doctor advertised in the Santa Cruz Good Times weekly newspaper.   I called, and the doctor answered.  I asked about cost, insurance, etc.  We made an appt for his partner for me.  This was followed by several confirming texts. (I like that)

 

He told me they accepted MEDICARE. That was very important.  He did say I would have to pay when I arrived, before I saw anyone there and MEDICARE would refund and they  (doctors office) would send in a request the same day.  I paid with my credit card (transaction with receptionist) and it shows on my statement: amount, date, and to whom paid. That amount is $289.09

 

As I was leaving I confirmed with the receptionist that she was sending it for a refund since MEDICARE would pay them.  I waited, I waited. I call for info. About 3 weeks pass since the doctor has been paid for the first appointment and where is my refund?

 

Finally I get a text from the doctor’s office that my refund check should arrive on the 11th of December.  No check. I keep asking and the doctor’s office assures me a check was mailed. Tired of it all (very tired after the energy drain of this year and pain paired with no results.) and I call MEDICARE. The person I speak to listens carefully and says I need to talk to billing and transfers me.

 

Billing dept very carefully listens and then also very carefully goes through all on my record and says the 11th represents not that a check has been made to me but that the dollars have been sent to doctor for a refund to me. However in a text to me the doctor’s office says MEDICARE sent the check for reimbursement on the 11th. Billing says “There is no check.”

 

Billing als says they agree I am due a refund from the doctor.

 

At this point, I  have  texted it all to the doctor and no responses. It appears the doctor has now been paid by me and by MEDICARE. Two payments for one appointment and I have no answers or refund.

 

I do however receive my electronic messages from MEDICARE at this point and see the doctor has also billed MEDICARE for the appointment again, this time by breaking the appt time down into various help methods used on me the same day. MEDICARE paid. This is now the third payment for the doctor for the same appointment.

 

Doctor’s office never veered from: The check is in the mail while MEDICARE says “no check ever sent”

 

Then the same appointment time (there is only that one visit) has now been used again. I was promised coverage by MEDICARE. Instead I became cash cow for doctor.