Session Costs

[kyshiag]

If we're doing all the work now with home HD, why is Davita charging even more for each session?

K.

[cattlekid]

Because they can.  My insurance company paid out over $350,000 for one year of home hemo to DaVita.  DaVita STILL chased me for $1200 in copays for that year. 

[Sydnee]

We recently found out BCBS only has 1 code for dialysis. It bugged us for months that on our explanation of benefits we got from BCBS always said hemodialysis even after Ed switched to PD. We thought FMC was billing wrong. We finally talked to the right person at FMC  someone who cared. Then Ed and the FMC billing person made a conference call to BCBS. They found out BCBS pays the same for dialysis no matter whether you go in center or at home,whether you do PD or hemo. It's all "hemodialysis" to BCBS.
kind of made us mad.
My question why is the center not trying to get everyone to do it at home?

[cattlekid]

Probably because of the ridiculous requirement in the United States that home hemo requires a partner.  This should be the decision of the patient, not of the dialysis organization.  But that is a rant for another thread.

We recently found out BCBS only has 1 code for dialysis. It bugged us for months that on our explanation of benefits we got from BCBS always said hemodialysis even after Ed switched to PD. We thought FMC was billing wrong. We finally talked to the right person at FMC  someone who cared. Then Ed and the FMC billing person made a conference call to BCBS. They found out BCBS pays the same for dialysis no matter whether you go in center or at home,whether you do PD or hemo. It's all "hemodialysis" to BCBS.
kind of made us mad.
My question why is the center not trying to get everyone to do it at home?

[reno2360]

Because they can.  My insurance company paid out over $350,000 for one year of home hemo to DaVita.  DaVita STILL chased me for $1200 in copays for that year.

You need to contact your insurance company ASAP and verify whether or not the copays that you are being billed for are being categorized as office co-pays.  If so you only owe that co-pay for office visits and not for each treatment done at home.  I used to do billing for Davita and they are very sloppy in that regard.   They don't care of the claim is processed incorrectly and if it shows a co-pay is owed in error for home treatment they will bill you for it.

[cattlekid]

No, it was right.  I have a $2000 per year OOP maximum for all claims.  So these claims were from early January 2012, when I was still getting through my 20% cost-sharing.  It just seemed almost comical to chase after someone for $1200 when the amount that was received was far greater than they would get from most of their Medicare patients.  I guess they just wanted their full pound of flesh where they could get it.

Because they can.  My insurance company paid out over $350,000 for one year of home hemo to DaVita.  DaVita STILL chased me for $1200 in copays for that year.

You need to contact your insurance company ASAP and verify whether or not the copays that you are being billed for are being categorized as office co-pays.  If so you only owe that co-pay for office visits and not for each treatment done at home.  I used to do billing for Davita and they are very sloppy in that regard.   They don't care of the claim is processed incorrectly and if it shows a co-pay is owed in error for home treatment they will bill you for it.

[Tío Riñon]

Because they can.  My insurance company paid out over $350,000 for one year of home hemo to DaVita.  DaVita STILL chased me for $1200 in copays for that year.

You need to contact your insurance company ASAP and verify whether or not the copays that you are being billed for are being categorized as office co-pays.  If so you only owe that co-pay for office visits and not for each treatment done at home.  I used to do billing for Davita and they are very sloppy in that regard.   They don't care of the claim is processed incorrectly and if it shows a co-pay is owed in error for home treatment they will bill you for it.

I have been on both Hemo (briefly) and PD for just over two years.  I have never paid an office co-pay for visits to the dialysis clinics/facilities.  I am charged co-pays for other medical appointments.  I have an annual OOP too, but dialysis never plays a role in it from what I can see.  Perhaps you should confirm the requirements for your insurance.