Will Medicare pay for……?

September 12, 2011 at 7:09 pm

That’s a good question. In an ideal world, the provider of the service you want will have a Financial person. Sit down and talk to them. You have to get past the front desk workers.

If you have medical service or condition code (ahh hha, I got it now- a diagnosis code) the provider can determine, immediately, if the procedure is covered.

Why? If a procedure is not covered, and the provider has not had you sign an Advanced Beneficiary Notice (ABN), then the provider does not get paid.

What you need is a determination which tells the provider this procedure is covered, or this procedure MAY NOT be covered. Hopefully, you get the former answer.