FAQ about Physicians Neck & Back Clinics (PNBC)’s Medicare Policy
For Patients
FAQ about Physicians Neck & Back Clinics (PNBC)’s Medicare Policy
- Why does PNBC have a different Medicare Policy than I am used to?
- I have supplemental insurance in addition to Medicare. Can I use that insurance to pay for treatment?
- I am over age 65. Are there any circumstances under which insurance will pay for my treatment at PNBC?
- I still think I can get Medicare to pay for this. Can’t I submit the bill to them?
- 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 a healthcare attorney to devise a program that allows PNBC of Central MN to get paid by Medicare patients. We now ask Medicare patients to pay a minimum charge of $1.000, a significantly reduced rate from our standard fees.
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 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.