I am being billed for a service that is provided without charge by Medicare
I am being billed for a service that is provided without charge by Medicare. I am being unfairly billed (Novant Acct#XXXXXXX) for an outpatient hospital visit and an EKG. I am on Medicare, Part A & B and Tricare for Life. On 9 December , I had an appointment in my primary provider's office for a Welcome to Medicare visit, yet I was billed for an outpatient hospital. An EKG was part of the Welcome to Medicare visit at my provider's office. Per the Medicare.gov website, a Medicare enrollee can receive and not be charged for the Welcome to Medicare introductory visit only within the first 12 months of being enrolled in Part B and that you should "Bring to the visit your medical records, family health history, and a list of prescription drugs, over-the-counter medicines, and supplements you are taking. Your doctor will record and evaluate your medical and family history, current health conditions, and prescriptions, and make sure you're up-to-date with preventive screenings and services. ...Part B covers an EKG or ECG (as a one-time screening with a referral from your doctor as part of your "Welcome to Medicare" preventive visit and as a diagnostic test.)" I have messaged Novant's billing department no less than 10 times and spoke to someone on the phone more times than I can remember. I also contacted Medicare via phone call and chat several times. I received an answer via phone with Medicare that I am being incorrectly billed for the visit on 12/9. When that failed to impress the Novant billing department, I contracted Medicare.gov on 2/12 and got a chat message from Medicare stating that, "Also from 12/9, there is a claim that was billed for $148.00, which is being rejected by Medicare. It was for Dr. John Weathers, and it was for the doctor's portion of the office visit, and an EKG. It shows it is being rejected by Medicare because there is a billing mistake. It says the place billing the claim is different than the provider who is on the claim. You are not responsible for the charges on this claim. A rejected claim like this means we need the provider to correct the claim before it is fully processed. This is claim number XXXXXXXXXXXXX. It shows they aren't allowed to bill you for anything on this claim." I sent this information in writing to Novant billing, vi*** account. When I received the same we-have-reviewed-and0-you-are-wrong-and we're-not-budging type of response, I once again contacted Medicare via chat on 3/5, and was told: "I am showing claim XXXXXXXXXXXXX from 12/9 is in a rejected status, which means the contractor has returned your claim to your provider because they need more information to process and pay your claim. Your provider needs to complete the missing information and file the claim again...If that provider accepts Medicare, but refuses to make the necessary corrections and resubmit the claim, you can call 1-800-MEDICARE and a representative can submit an assignment violation because that provider is required by law to submit claims to Medicare." I have been advised by Medicare not to pay this bill and that this agency is in violation if they even bill me for this visit. Yet, Novant continues to reply to my requests to resubmit to Medicare with what I can only describe as a "canned" reply that they have reviewed my record, made no errors, and will not resubmit. I receive monthly statements in the mail for a hospital visit on this date. I have taken one of these bills directly to my provider's office to ask for help and was got no further than the front desk where I was told "it is not my job". I even called Novant again to tell them that my spouse is covered by the same insurance and was not billed for his previous "Welcome to Medicare" visit. I am at a loss with how to communicate with these people, and I feel certain they plan to turn me over to collections. If I pay this bill, which is not even legally charged, I expect that whatever Medicare billing errors this agency made in my account will become the norm. Can you please help?
The complaint has been investigated and resolved to the customer’s satisfaction.
I went into the Novant medical office for an initial screening / consultation. I was in the office 17 minutes including wait time. The Dr. was in the office maybe 7 minutes. The office visit charge was $484 - no tests, etc... insurance only covered 200 so left with a $200+ bill for 17 minutes. Seems outlandish to me.