Why does PNBC have a different Medicare
Policy than I am used to?
To understand why
and how this program was developed, some history is
necessary. PNBC was founded in 1990,
and due to bureaucratic red tape, we decided we would
not treat any Medicare patients. However, we began to get calls from physicians
asking us to evaluate some of their Medicare patients. As a courtesy, we
performed
these evaluations and found that many of these patients responded positively
to the PNBC program. We considered joining the Medicare program at that time,
but after another review with experts, we again concluded that the burdens
placed on the clinic and the billing department were
not worth it and also not consistent
with good health care. Instead, we decided that when we treated Medicare
patients, we would simply treat them for free. Initially,
they were a small part of our
practice and it was our way of giving back to the community. However, we
began to get more and more Medicare patients, and the
cost of providing the treatment
became too big of a burden. Many of those patients did well and wanted to
pay us for their treatment, but Medicare rules at the
time prevented that. A few
years ago the rules changed.
In 2001 we consulted with a healthcare attorney
to see if we could devise a program that would allow
us to get paid by patients who had the financial
means
and felt the treatment was beneficial but still allowed us to treat other
Medicare patients at no charge. Thus, our current program was developed.
PNBC
physicians could choose to treat Medicare patients under the traditional
system. None of our physicians have any restrictions regarding Medicare patients
nor have any ever been barred from the program. Instead, we have chosen not
to accept Medicare because the current Medicare system is overburdened with
bureaucratic red tape.
I have supplemental insurance in addition to Medicare.
Can I use that insurance to pay for treatment?
Only if your supplemental
insurance is your “primary” insurance.
Our billing office or front desk personnel will be able to determine this
by contacting your insurance company.
I am over age 65. Are there any circumstances
under which insurance will pay for my treatment at PNBC?
Possibly. If you have a supplemental
or secondary insurance plan which is considered “primary” over
Medicare for services offered at PNBC, or if your plan has an “opt
out clause.” By supplying our front desk personnel or billing office
with your plan name and ID/Group numbers, we can contact your insurance
company
to make this determination.
I still think I can get Medicare
to pay for this. Can’t I submit the
bill to them?
No. In order to enroll in our program, you have to sign a contract with
PNBC. In that contract you agree not to submit any bills to Medicare.
It is simply
against the law.
