Home Dialysis Central

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  1. #1
    Join Date
    12-19-16
    Posts
    3

    Default Think my mother is being overbilled

    My mother is receiving home dialysis and she is not on Medicare yet. I took a look at her EOBs and bills and noticed that the company is billing her for each visit with a charge for the equipment, scale, etc. that actually stays at her home. This does not seem correct but the company said this is totally fine. They charge $29 for a scale for each day of home hemodialysis. Can someone help me?

  2. #2
    Join Date
    06-25-04
    Location
    Kansas
    Posts
    1,769

    Default Re: Think my mother is being overbilled

    Until someone has Medicare, dialysis companies usually bill the patient's insurance for everything it provides, including things like scales, etc. If your mother is on home dialysis and if she has enough work credits herself or through a spouse, she should be eligible for Medicare. Medicare A and B can be backdated to the month she started dialysis. If her insurance now is through an employer, that plan would be billed and pay first for the first 30 months she's eligible for Medicare whether she has it or not. Having Medicare as a primary or secondary payer limits what a dialysis clinic (and any other provider that accepts Medicare assignment) can charge her. The savings usually more than offset the cost of the Part B premium.

    NOTE: If the company is providing staff to do her home hemodialysis, her insurance may be covering that. Medicare doesn't cover "staff-assisted home dialysis." Patients can be trained to do all or most of the dialysis themselves. Most patients use family members or friends as free care partners.
    Beth Witten MSW ACSW LSCSW
    Medical Education Institute, Inc.

  3. #3
    Join Date
    12-19-16
    Posts
    3

    Default Re: Think my mother is being overbilled

    Hi Beth! thank you so much for your insight. She does have someone helping her but all the equipment is left at her home (ie. scale) and they are charging her per day for the use of her machine, scale , etc. Seems very strange to charge someone $29 per day for a scale

  4. #4
    Join Date
    06-25-04
    Location
    Kansas
    Posts
    1,769

    Default Re: Think my mother is being overbilled

    Dialysis facilities/companies often bill what they think insurers will pay. I agree $29/day sounds excessive for a scale. Is the $29/day billed to her insurance or does she have to pay that? Does she have insurance through an employer or does she have an individual qualifying health plan that she bought on or off the health insurance marketplace? Does she get her dialysis through a dialysis corporation? Which one? Has anyone explained the benefits of having Medicare and the risks of not having it if she has an individual plan instead?
    Beth Witten MSW ACSW LSCSW
    Medical Education Institute, Inc.

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