New Medicare Patients

At the present time we are not accepting new Medicare patients. If you are a current patient who became medicare age (65), we will continue with you care, and we will file your clain with Medicare.

Denial of Payment for Health Services by Medicare

Current Medicare law allows the government to deny payment for medical services rendered to you which it (the government) feels are "not reasonable and necessary". This is one of the techniques used by the government to cut its costs for your health care. The reasons the government uses to determine a medical service is not reasonable or necessary may change from time to time. For this reason it is impossible for us to accurately predict which services the government may deny, if any.

Denial of payment for medical services by Medicare usually falls into one of the following categories:

1. Medicare does not usually pay for this many visits or treatments.
2. Medicare usually does not pay for this service.
3. Medicare usually pays for only one nursing home visit per month.
4. Medicare usually does not pay for this shot.
5. Medicare usually does not pay for this many shots.
6. Medicare does not pay for this because it is a treatment that has yet to be proved effective.
7. Medicare does not pay for this office visit unless it was needed because of an emergency.
8. Medicare usually does not pay for like services by more than one doctor during the same time period.
9. Medicare usually does not pay for this many services within this period of time.
10. Medicare usually does not pay for more than one visit a day.
11. Medicare usually does not pay for such an extensive procedure.
12. Medicare usually does not pay for like services by more than one doctor of the same specialty.
13. Medicare usually does not pay for this equipment.
14. Medicare usually does not pay for this lab test.
15. Medicare usually does not pay for this service for reasons it has determined.

Medicare Fee Schedule

Under a provision of the Medicare law, we are only allowed to charge you a fee predetermined by the US government, called a MAAC (Maximum Actual Allowable Charge). In most cases the MAAC requires us to "discount" the services rendered to you by as much as 50% less than our regular fee schedule. For this reason we are not able in many cases to charge Medicare patients what our actual COST is to render the service to you. Since we must discount our services to you in the first place, often to a level below cost, it is important that you be responsible for paying any portion of your bill that the government does not cover. It is our pledge to provide you with only those services which the doctor feels are absolutely necessary to diagnose, treat, or evaluate your health.

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