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Author Topic: Dialysis Center Charging My Medicare For Non-Treatment Days?  (Read 4013 times)
briellegazzara
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« on: May 17, 2013, 06:47:11 AM »

So, I got my EOB for March and saw what my dialysis clinic charged my Medicare for my home hemo treatments. ( outrageous by the way! Can't believe thay charge MORE for home hemo then in center!) but anyway I had problems with my machine, then with the PureFlow so I only got in 14 treatments in the month of March. My dialysis unit charged my insurances for 17 treatments. Has anyone else had this happen? Are they suppose to do that? My clinic is Davita. Thanks for your reply!:))
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23 years on dialysis
PD 6 years
In-center hemo 17years
Home hemo 1 year (currently doing!)
Transplanted 2 times, failed both
cdwbrooklyn
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« Reply #1 on: May 17, 2013, 02:22:50 PM »

True, it is more than what the center is charging; however, I have Medicare which pays 80% of what Medicare is willing to pay.  My company insurance pays 20% of what Medicare is willing to pay.  I got a bill for $2000 per home treatment. I took it to my nurse and she told me that Medicare is not paying that amount of money to DaVita.  So if you have Medicare, your company insurance is only responsible of paying 20% of what Medicare is willing to pay.   

When it comes to home treatments, you are charged based on the order your doctor gives you. For example, if your doctor gives you an order of 6 times a week but you choose to do it 5 times a week, you will still be charged 6 times a week until your doctor changes the order.

Hope this helps!!!    8)

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Dailysis patient for since 1999 and still kicking it strong.  I was called for a transplant but could not get it due to damage veins from extremely high blood pressure.  Have it under control now, on NxStage System but will receive dailysis for the rest of my life.  Does life sucks because of this.  ABOLUTELY NOT!  Life is what you make it good, bad, sick, or healthy.  Praise God I'm still functioning as a normal person just have to take extra steps.
Bill Peckham
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« Reply #2 on: May 17, 2013, 08:43:13 PM »

So, I got my EOB for March and saw what my dialysis clinic charged my Medicare for my home hemo treatments. ( outrageous by the way! Can't believe thay charge MORE for home hemo then in center!) but anyway I had problems with my machine, then with the PureFlow so I only got in 14 treatments in the month of March. My dialysis unit charged my insurances for 17 treatments. Has anyone else had this happen? Are they suppose to do that? My clinic is Davita. Thanks for your reply!:))


Uh no that's fraud (or possibly an accident) . Are you faxing your run sheets to your unit daily or do you turn them in? The billing should be done by the unit on or after the first of the following month and should reflect the actual number of treatments you reported.


Have previous months matched?
« Last Edit: May 17, 2013, 08:45:23 PM by Bill Peckham » Logged

http://www.billpeckham.com  "Dialysis from the sharp end of the needle" tracking  industry news and trends - in advocacy, reimbursement, politics and the provision of dialysis
Incenter Hemodialysis: 1990 - 2001
Home Hemodialysis: 2001 - Present
NxStage System One Cycler 2007 - Present
        * 4 to 6 days a week 30 Liters (using PureFlow) @ ~250 Qb ~ 8 hour per treatment FF~28
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