Discussion in 'Fibromyalgia Main Forum' started by NanceZ, Oct 28, 2005.
Did you really write that Medicare paid for all of your FFC costs? You had to pay none?
Oh no, Nancez. What they did pay for was my LAB COSTS ONLY, the blood work. They did not pay for office visit, supplements or prescription meds.
So sorry if I misled you. I went back to the post to clarify.
I was ever so hopeful
At least it can help with some of the costs, maybe making it possible.
How do you submit a claim to Medicare for the lab work at FFC? I have an appt. in the LA area on Nov. 9th at the FFC. I'm very worried about the costs. Do you know how much the first visit is?
Do they submit to Medicare? Sorry about all of the questions.
I understand your worries about costs, and especially the not knowing exactly how much and who will end up paying.
FFC does not take Medicare at all. However, they have a Quest Lab onsite, which is separate from them. Quest is the one that takes the insurance.
On my first visit I presented Quest Lab with my insurance cards, not really knowing what would happen, esp. because Medicare is new to me. Medicare is my primary ins. and I have a secondary private ins. The tech took a copy of my cards, and completely took care of the billing.
After a long wait I received from Medicare a statement of benefits on this set of labs from my first appointment.
The charges were $2152. Medicare, my primary insurance, paid Quest at their allowable rate, which came to $362. I paid zero, and am not responsible to pay anything further. This is for the labs only.
I had a second set of labs done to check for all of the underlying viruses and infections. That was also completely covered by Medicare.
This week I just had an Igenex test done for Lymes, and I believe (and hope) that it will also be covered, it runs about $350.
Other FFC visit costs:
My first visit was $325 in Cleveland. All visits since have been $165. ( I recently transferred to Seattle, same costs.) These are not covered by Medicare. And since Medicare won't pay them, neither will my private ins. FFC expects payment at time of service. They accept credit cards and also have a special credit card plan you can call and ask about.
IV therapies, which are optional, run between $90-$115 I think, depending on which one. They also offer a package deal special on some of the IVs.
The remaining costs are for vitamins/supplements, compounded bio-identical hormones, and any prescription medications. I pay for the vitamins/supplements out of pocket. I can't really give you a figure on that because I take so many from other doctors as well. I'll just guess that from the FFC only is about $300/mo. at this time for vitamins/supplements/herbal meds. (Once I'm stabilized this will be cut way back.)
My private insurance pays for most of the bio-identical (currently just T3, although previously took testosterone and cortisol as well), and for most of the RX meds.
I hope this helps you get an idea of what to expect. At first it all seems so expensive and shocking, and it is. However, I do not think that their charges are out of line with what other doctors charge. Some supplements can be purchased elsewhere a bit cheaper.
My philosophy is that regaining our health is an INVESTMENT in ourselves, our lives, and our future. Esp. for me, as a breast cancer survivor, I'm out to beat this, and live my life to the fullest. I wish you the very same.
Have a beautiful day,
[This Message was Edited on 10/29/2005]
Thak you so much for your detaile dreport onthe costs you've found at the FFC.
The thing that confuses me is this: You wrote: "The charges were $2152. Medicare, my primary insurance, paid Quest at their allowable rate, which came to $362. I paid zero, and am not responsible to pay anything further. This is for the labs only."
There's a big difference between $2125 and $362........how did that get covered?
Thak you so much....and I'm with you, it's all an investment in our lives, and the quality of them. I am getting better centimeter by centimeter in the regimen I'm following so it's just a balancing act to figure out if the FFC's could giv eme a faster boost.
Again, thank you
Not only is it confusing, it's unbelievable! I actually had to call Medicare once I received the statement of benefits to find out if I would have to pay the remainder.
To the best of my understanding, when Quest signed up to be a Medicare provider it also agrees to accept the Medicare "allowable" benefit amount on any given test. Once it covers that amount Quest cannot bill you/me for anything else.
I don't know if this applies to all lab tests, but I have to say that Quest did some extremely thorough testing job! I think I received 18 pages of test results.
I also paid nothing on the viral/infectious testing. I also have labs done every 3-4 months on order from my oncologist, and have paid nothing for those labs.
Are you new to Medicare? I have called their 800 number on the card quite a few times with my questions. At first, you get looped around the voice computer thing, but once you get the real person, I have found them extremely helpful and patient. If I ask them to speak slower, or repeat or whatever, they have still been very respectful and helpful...not bad for a government agency under lots of stress.
The vast discrepancey between the charges and what Medicare pays just makes me wonder even more about our entire health care system, the rising cost of health care, and who really benefits? No wonder many places do not want to deal with Medicare re: low payment amounts.
Wishing you well,
time and energy to write about your costs at the FFC. There are many times that I want to respond to sommeone but am just too tired. Your mind seems to be working very well!
I wonder if your secondary insurance paid any of the labs? As Nancez pointed out that is a very big difference in what Quest billed and what they accepted for payment.
I agree with you that our health is the most important thing. I think that many of us have put out so much money in the past for supplements and anything that we can grab onto that may help us therefore another large chunk of money really hurts, but if it helps then we can go out and make more money!
I'm looking forward to going to the FFC here. I hope that I have the results that so many seem to be getting!
Thanks again for your info!
Beautiful days ahead to you,
[This Message was Edited on 10/29/2005]
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