Donna Vetters
@deemedic.bsky.social
Irreverent, unapologetic, wiseass, and obnoxious. Like me now?
So sorry for your loss. ❤️
March 18, 2025 at 12:44 AM
So sorry for your loss. ❤️
Yes absolutely agree with you on that.
March 5, 2025 at 3:21 AM
Yes absolutely agree with you on that.
Unless they don’t accept assignment which case they can only take 15% more from the patient than what they owe
March 2, 2025 at 12:23 AM
Unless they don’t accept assignment which case they can only take 15% more from the patient than what they owe
Not getting on you or anything I’m sure they probably did tell her that I’m just saying this is the way it works on the back end and I understand that and so I was just trying to explain that a doctor doesn’t make what you think he does and he doesn’t pocket anything over the amount they’re given
March 2, 2025 at 12:22 AM
Not getting on you or anything I’m sure they probably did tell her that I’m just saying this is the way it works on the back end and I understand that and so I was just trying to explain that a doctor doesn’t make what you think he does and he doesn’t pocket anything over the amount they’re given
It is required that insurances and entitlements send explanation of benefits for every claim received by them for just this purpose. This is how most legit fraud is reported But most people’s EOBs end up in the trash or not even acknowledged. READ YOUR EOBs!
February 28, 2025 at 5:34 PM
It is required that insurances and entitlements send explanation of benefits for every claim received by them for just this purpose. This is how most legit fraud is reported But most people’s EOBs end up in the trash or not even acknowledged. READ YOUR EOBs!
Medicare pays for claims they are sent. Due to government regulations if there is no red flags, bad coding, or some other concern they pay the claim. If a patient reports, red flags add up, or a pattern of abuse is noticed the audit processes begin. Then if you are bad you get busted.
February 28, 2025 at 5:28 PM
Medicare pays for claims they are sent. Due to government regulations if there is no red flags, bad coding, or some other concern they pay the claim. If a patient reports, red flags add up, or a pattern of abuse is noticed the audit processes begin. Then if you are bad you get busted.
I have to call BS on that one. MCARE fraud is taken very seriously especially if a beneficiary reports it. There are many avenues to report abuse other than calling a 18/hr CSR. Have them go to the Medicare.gov website and search out fraud and abuse and you can even submit the report on line.
Welcome to Medicare
The official U.S. government website for Medicare, a health insurance program for people age 65 or older and younger people with disabilities.
Medicare.gov
February 28, 2025 at 5:22 PM
I have to call BS on that one. MCARE fraud is taken very seriously especially if a beneficiary reports it. There are many avenues to report abuse other than calling a 18/hr CSR. Have them go to the Medicare.gov website and search out fraud and abuse and you can even submit the report on line.
Again, you can charge what you want but you will only get paid what they allow anyway.
February 28, 2025 at 5:19 PM
Again, you can charge what you want but you will only get paid what they allow anyway.
When the Marshalls show up they are just the law enforcement aspect and PHI is generally kept from them but the program integrity people, recovery contractors and all of the research and investigation folks are considered HIPAA entities as a matter of law. So as long as they exercise all due care…
February 28, 2025 at 5:18 PM
When the Marshalls show up they are just the law enforcement aspect and PHI is generally kept from them but the program integrity people, recovery contractors and all of the research and investigation folks are considered HIPAA entities as a matter of law. So as long as they exercise all due care…
And DME companies can literally just make up patients and supplies and get money that way. Just like Rick Scott and a bunch of illegal ops in FL. But what people don’t know is that checks and balances for this were put in place by CMS over 10 years ago. Sorry so long just want to give a little edu
February 27, 2025 at 6:51 PM
And DME companies can literally just make up patients and supplies and get money that way. Just like Rick Scott and a bunch of illegal ops in FL. But what people don’t know is that checks and balances for this were put in place by CMS over 10 years ago. Sorry so long just want to give a little edu
The primary fraud that is committed most often is by big hospitals and DME companies. It’s extremely easy for a hospital to bill for treatments that the patient didn’t have because hospital claims have so many services on them who is going to notice if they put extra tests or services on there - 4
February 27, 2025 at 6:49 PM
The primary fraud that is committed most often is by big hospitals and DME companies. It’s extremely easy for a hospital to bill for treatments that the patient didn’t have because hospital claims have so many services on them who is going to notice if they put extra tests or services on there - 4