CheckEmoji Community · the emoji forum
🏠 Home 🆕 What's new ❓ Unanswered 🔥 Popular 📡 RSS Members 👥 0 online log in · register
Home › Lifestyle › Health › Hospital denying coverage for scans

Hospital denying coverage for scans

Started by Alexander Lewis · · 👁 4 views · 1 reply

📡 Subscribe to replies

Participants Alexander LewisAngela Wright
Alexander Lewis Alexander Lewis MemberOP
49 messages
joined May 2014
#1 ·
So, here’s a situation unfolding in Washington, D.C.: a patient is currently being treated at Hospital A. He needs several diagnostic tests performed, which happen to be a bit more expensive for the facility to run. Instead of just getting on with it, Hospital A suddenly claims they can't perform them and tells him he needs to go to Hospital B. When he shows up at Hospital B, they pull this ridiculous stunt where they claim they don't perform tests for patients who aren't "theirs," suggesting he check back in a month or two when they might actually be able to help.
Naturally, nobody is willing to put any of this nonsense in writing.

A few questions:
1. What is this logic regarding being a "Hospital A" versus a "Hospital B" patient? This man is a Medicare beneficiary; shouldn't he have the right to receive treatment at any facility that holds a contract with Medicare?
2. What legal or administrative hurdle prevents him from simply registering for those tests at the second hospital?
3. Who should he file a formal complaint with at Medicare, given that both hospitals are failing to meet their contractual obligations?
Angela Wright Angela Wright Regular
731 messages
joined Feb 2007
#2 ·
Alexander Lewis said:In Washington, D.C., a guy is being treated at Hospital A. He needs a few tests done that cost the hospital a bit more money. Instead of just doing them, Hospital A suddenly claims they can't perform those specific tests right now and tells him he needs to go to Hospital B. So, he heads over to Hospital B, only for them to tell him they don't run tests for patients who aren't "theirs," suggesting he check back in a month or two when they might be able to accommodate him.
Of course, nobody will give you anything in writing.

Questions:
1. What's this whole deal with being a "Hospital A" vs. "Hospital B" patient? This man is covered by Medicare, and as an insured person, shouldn't he have the right to receive treatment at any facility that has a contract with Medicare?
2. What exactly is stopping him from registering for those tests at the second hospital?
3. Who do you complain to at Medicare when both hospitals are failing to meet their contractual obligations?

1. It’s basically just internal finger-pointing between Hospital A, Hospital B, and Medicare, even though an insured individual has every right to get those tests performed.

2. It's usually their residency; they use your zip code to claim you belong to a different network—that's their favorite excuse to dodge responsibility.

3. You can either pray to Saint Peter or just charge in there, start yelling, and threaten to call the local news or a major TV station. Though, honestly, even that might not work; they'll probably find some way to make you look like the crazy one by claiming you misheard someone or misquoted a doctor. Alternatively, if you actually have the cash, you can just bypass the headache and pay for a private clinic to do the tests.
Medicare is a total nightmare!😠

You must log in or register to reply here.

Log in Register

🔗 Similar threads