Wiki Medicare And Office Visits Limits

[NEWSAN123]

Does Anyone Know If There Is A Limit On Number Of Visits Medicare Will Pay? Also, Would You Recommend Pt Signing An Abn For Visits That May Not Be Payable Due To "abuse" :we Have One Pt That Is Constantly Finding Reasons For Appointments, We Try To Keep Him Outside Of The 10day Global Period For Ov But He Still Averages Coming Back About Every 2-3 Weeks.
Thanks
Ms

 

[rthames052006]

Does Anyone Know If There Is A Limit On Number Of Visits Medicare Will Pay? Also, Would You Recommend Pt Signing An Abn For Visits That May Not Be Payable Due To "abuse" :we Have One Pt That Is Constantly Finding Reasons For Appointments, We Try To Keep Him Outside Of The 10day Global Period For Ov But He Still Averages Coming Back About Every 2-3 Weeks.
Thanks
Ms

I know that there is a lifetime max on certain things but not sure if it relates to OV's. I would call the carrier and explain the situation and see what advice/help they can give you. It's not a bad idea to have him sign an ABN and explain it to him, maybe if he realizes that there is a chance his insurance won't pay for his visit, he will stop abusing the situation.

Good luck

 

[Teresa Toscano]

IT IS MY UNDERSTANDING THERE IS NO MAX ON OFFICE VISITS FOR MEDICARE RECIPIENTS, ALTHOUGH YOU HAVE EXPRESSED A VERY IMPORTANT CONCERN. I AM SURE MANY PHYSICIANS ARE HAVING TO TRY AND CONQUER EACH AND EVERYDAY TO MAKE SURE A PATIENT IS CARED FOR IN A ETHICAL MANNER, BUT THE PATIENT DOES NEED TO BE HELD ACCOUNTABLE FOR THEIR ACTIONS ON WHETHER OR NOT THEY ARE HAVING ALL "KINDS" OF SYMPTOMS JUST TO GET IN TO SEE THE DOCTOR. I AGREE WITH THE PREVIOUS BLOG ON CONTACTING THE CARRIERS ABOUT MAXES EACH YEAR ON PROCEDURES, ETC. MAYBE THIS PATIENT NEEDS TO BE REFERRED TO A PHYSICIAN WHO CAN BETTER UTILIZE AND CONTROL THE PATIENTS FEELING OF NECESSITY. IN OTHER WORDS MAYBE A "PSYCHOLOGISTS". HMMM... I HOPE THIS HELPS!!